Post-Surgery Recovery: Delayed Healing After Hemorrhoid and Fissure Surgery - Surgery

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More than two months post-surgery?


Hello Doctor: I underwent minimally invasive surgery for anal fissure and hemorrhoids in mid-November last year.
However, it has been over two months post-surgery, and the wound has still not healed.
After taking a sitz bath, I can see a red area at the anal opening that looks like a wound, and there is still a small amount of milky white discharge.
Currently, I continue to have sitz baths twice after bowel movements and showers, and I take softeners and anti-inflammatory medication twice a day.
Is this normal? I read online that recovery typically takes about a month.
I had my anal fissure for several years before addressing it; could this be the reason for the slow healing process? During my follow-up appointment, my attending physician prescribed suppositories and antibiotics, but I have tried multiple times to insert the suppositories without success.
I might be using the wrong technique, and I am also afraid that forcing it could cause the wound to reopen.
If this drags on for three months, will it turn into a chronic anal fissure? The thought of needing another surgery is very stressful.
Thank you for your response.

Yi, 20~29 year old female. Ask Date: 2024/01/20

Dr. Zhang Shuhao reply Surgery


The healing speed of hemorrhoid and anal fissure surgeries varies depending on the size of the wound.
Complex wounds may take longer to heal, so it is recommended to have regular follow-up visits to monitor the wound.
Suppositories can be refrigerated to maintain their shape; before insertion, apply a small amount of ointment for lubrication.
When inserted beyond the anal sphincter, they will naturally slide in.
Anal fissure surgery involves excising the inflamed tissue and relaxing the anal sphincter to allow the wound to heal properly, which reduces the likelihood of developing new chronic anal fissures postoperatively.

Reply Date: 2024/01/20

More Info


Post-surgery recovery, especially after procedures like hemorrhoid and fissure surgery, can be a complex process influenced by various factors. It's not uncommon for patients to experience delayed healing, and your situation is not unique.
After undergoing minimally invasive surgery for anal fissures and hemorrhoids, many patients expect a relatively quick recovery, often within a month. However, individual healing times can vary significantly based on several factors, including the severity of the initial condition, the extent of the surgical intervention, and the patient's overall health and lifestyle.

In your case, the presence of a persistent wound that appears red and discharges a whitish fluid could indicate several possibilities. It might be a normal part of the healing process, especially if the area is still inflamed. However, it could also suggest an infection or a delayed healing response. The fact that you have been experiencing this for over two months does raise some concerns, and it would be prudent to discuss these symptoms with your healthcare provider.

Chronic conditions, such as long-standing anal fissures, can indeed complicate recovery. If the fissure has been present for years, the surrounding tissue may have developed scar tissue or other changes that could impede healing. Additionally, factors such as diet, hydration, and bowel habits play a crucial role in recovery. Ensuring that you maintain a high-fiber diet, stay well-hydrated, and use stool softeners as prescribed can help minimize strain during bowel movements, which is essential for healing.

Regarding the use of suppositories, it's understandable to feel apprehensive about inserting them, especially if you're concerned about causing further damage to the surgical site. If you're having difficulty with the suppositories, it might be helpful to consult your doctor or a nurse for guidance on the correct technique. They can provide tips on how to administer them more comfortably and effectively. If the suppositories are causing pain or discomfort, it may be worth discussing alternative treatments or medications with your healthcare provider.

If you find that your symptoms do not improve or worsen, it is crucial to follow up with your doctor. They may recommend additional interventions, such as a different type of medication, further evaluation of the wound, or even a referral to a specialist if necessary.
In terms of your concern about developing a chronic fissure if healing does not occur, it is essential to address this proactively. Chronic fissures can indeed require more invasive treatments, including repeat surgery. However, many patients can achieve healing with appropriate management and care.
In summary, while it is not uncommon to experience delayed healing after hemorrhoid and fissure surgery, it is essential to remain vigilant and proactive in your recovery. Regular follow-ups with your healthcare provider, adherence to prescribed treatments, and open communication about your symptoms will be key to ensuring a successful recovery. If you have any concerns about your healing process, do not hesitate to reach out to your healthcare team for support and guidance.

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