Persistent Anal Wound After Hemorrhoid Surgery: Healing Tips - Surgery

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The anal wound has not healed?


Hello Doctor, since my hemorrhoid surgery on December 27, 2023, I have been using moist wipes to clean myself after bowel movements, followed by washing with warm water and taking sitz baths.
I'm not sure if I have been rubbing too hard, but I have developed a small wound near the anal area that is swollen and slightly painful.
There is a bit of blood on the wipes.
I have been applying ointment for two weeks, but there has been no improvement.
Should I avoid sitz baths for now to allow the wound to dry out and heal better? I also purchased a topical ointment containing gentian violet; is that appropriate? Thank you for your response.

Miss Chen Taipei, 30~39 year old female. Ask Date: 2024/01/22

Dr. Zhang Shuhao reply Surgery


After surgery, try to minimize irritation to the anus.
If the wound is not swollen, you may temporarily stop sitz baths.
Povidone-iodine ointment is an antibiotic ointment that can be used.
If symptoms do not improve, it is advisable to return for a follow-up examination of the wound.

Reply Date: 2024/01/22

More Info


After undergoing hemorrhoid surgery, it is not uncommon for patients to experience complications such as persistent anal wounds. The situation you described, where you have a wound near the anal area that is swollen, slightly painful, and has some bleeding, is concerning and warrants careful management. Here are some insights and recommendations based on your situation.


Understanding the Healing Process
Following hemorrhoid surgery, the anal area can be quite sensitive and may take time to heal. The healing process can be influenced by several factors, including the surgical technique used, the extent of the surgery, and individual patient factors such as overall health and hygiene practices. It is essential to maintain proper hygiene while avoiding any actions that could irritate the area further.


Hygiene Practices
1. Gentle Cleaning: It is crucial to clean the area gently. While using moist wipes can be beneficial, ensure that you are not applying too much pressure, as this can exacerbate irritation. After bowel movements, consider using a gentle, non-irritating soap and warm water instead of wipes if you find them too abrasive.

2. Avoiding Irritation: If you suspect that rubbing too hard is causing irritation, it may be wise to reduce the frequency of vigorous cleaning. Instead, you can use a sitz bath (a shallow bath for the buttocks and hips) to soothe the area without the need for excessive wiping.

3. Sitz Baths: Regular sitz baths can help promote healing by increasing blood flow to the area and providing relief from discomfort. However, if you notice that soaking is causing more irritation or bleeding, you might want to limit the duration and frequency of these baths.


Topical Treatments
You mentioned using a topical ointment, specifically a purple ointment (likely referring to a type of antiseptic or antibiotic cream). While topical treatments can be beneficial, it is essential to ensure that the product is appropriate for use in the anal area. Some ointments may cause irritation rather than healing.
- Consultation with a Healthcare Provider: It is advisable to consult with your surgeon or a healthcare provider about the specific ointment you are using. They may recommend a different topical treatment that is more suitable for your condition.


When to Seek Further Medical Attention
If the wound does not show signs of improvement after two weeks of treatment, or if you experience increased pain, swelling, or discharge, it is crucial to seek medical attention. Persistent wounds may indicate an infection or other complications that require professional evaluation and possibly further intervention.


Additional Recommendations
- Dietary Considerations: Ensure you are consuming a high-fiber diet to prevent constipation, which can strain the anal area during bowel movements. Staying hydrated is also essential.

- Avoid Straining: When using the bathroom, avoid straining, as this can put additional pressure on the surgical site and hinder healing.

- Rest and Recovery: Allow your body time to heal. Avoid heavy lifting or strenuous activities that could stress the area.


Conclusion
In summary, while it is normal to experience some discomfort and slow healing after hemorrhoid surgery, persistent wounds should be monitored closely. Adjusting your hygiene practices, using appropriate topical treatments, and consulting with your healthcare provider are essential steps to promote healing. If symptoms persist or worsen, do not hesitate to seek further medical advice. Your health and comfort are paramount, and timely intervention can prevent complications.

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