Post-Surgery Woes: Healing Concerns After Hemorrhoid Removal

Q: Post-Surgery Woes: Healing Concerns After Hemorrhoid Removal

Hello, in response to your questions： <br>1. <br>Based on your description, it seems you underwent extensive surgery for large internal and external hemorrhoids, along with flap repair. <br>Generally, such a significant procedure requires a longer recovery time. <br>Typical recov

The wound has not improved even after 8 days post-hemorrhoid surgery?

Hello Dr.
Ke,
I had a mole excision surgery on April 1st (the internal mole was close to the ring, and the doctor said to use the external mole to fill in the internal one).
It has been 8 days now, and the stitches have already fallen out, but the wound still shows no signs of healing, which makes me very worried.
I usually soak the area in diluted Betadine and warm water 5-6 times a day, and I also soak after bowel movements.
The only medications the doctor prescribed were painkillers, a stool softener, and stomach medication.
It wasn't until my follow-up appointment yesterday that I received an ointment to apply, but the doctor instructed me to insert my hand to apply the medication, which I really cannot do because it is extremely painful.
Therefore, I can only apply the ointment externally.

The wound looks like raw flesh without any skin covering it.
I am really concerned if this treatment of taking medication, applying ointment, and soaking will actually help.
The doctor also told me to clean the wound thoroughly after bowel movements, but I can only clean the outside since I cannot insert a cotton swab to clean the inside due to the pain, and I am afraid to apply the ointment internally.
Will this affect the healing of the wound? The doctor mentioned that I would recover in two weeks, but I am really skeptical.
Right now, I cannot go anywhere because I feel the urge to have a bowel movement at any moment, and I need to soak in warm water to reduce the pain.
However, it is still very painful during bowel movements, to the point where I feel like I can't bear it, and I end up crying from the pain.

I have asked the doctor if I should receive anti-inflammatory injections or other treatments to help with the healing, but he said those would not be effective.
I am really doubtful about this.
Before the surgery, the doctor kept telling me it wouldn't be very painful and that with proper care, I would heal quickly, but that has not been the case.
So now, I find it hard to trust what the doctor says, especially since my wound is so large.
I am very worried.
I cannot work in this condition, and I am wondering what I should do if it is not healed in another week.
I don't know what methods can help my wound heal sooner.
Dr.
Ke, please help me and give me some advice.
I would be very grateful.

Sandy, 20~29 year old female. Ask Date: 2005/04/10

Dr. Ke Fangxu reply Surgery

Hello, in response to your questions:
1.
Based on your description, it seems you underwent extensive surgery for large internal and external hemorrhoids, along with flap repair.
Generally, such a significant procedure requires a longer recovery time.
Typical recovery for hemorrhoid surgery is about one week, but for anal hemorrhoid surgery combined with flap grafting, recovery may take approximately 2 to 3 weeks.
2.
If you are still experiencing pain at the wound site, I personally do not recommend applying ointment inside the anal canal, as it may cause further pain and could potentially harm the surgical site.
3.
The frequent urge to defecate is likely due to the wound not being fully healed.
At this stage, the injury may cause abnormal sensations in the anal area, which is a temporary phenomenon and should return to normal in about one to two weeks.
4.
There are indeed no injections that can expedite wound healing.
However, it is confirmed that taking warm sitz baths can alleviate pain and promote healing, while also keeping the wound clean and enhancing blood circulation, making it beneficial with no harm.
5.
Since I have not seen the wound myself, I cannot assess its size or condition.
However, generally, flap graft healing takes longer.
The key point to monitor is whether the graft is healing properly.
If the flap does not heal well, the recovery time will be extended, and there may be a certain degree of complications.

Reply Date: 2005/04/10

More Info

After undergoing hemorrhoid removal surgery, it is understandable to have concerns about healing, especially when pain and discomfort persist. From your description, it seems you are experiencing significant pain and are worried about the healing process of your surgical site. Here are some insights and recommendations based on your situation.

Firstly, it is important to recognize that pain after hemorrhoid surgery is common, especially in the initial days following the procedure. The surgical site can be quite sensitive, and the healing process can vary significantly from person to person. Generally, it can take anywhere from a few days to several weeks for the area to heal completely, depending on the extent of the surgery and individual healing factors.

The fact that your stitches have fallen out after eight days is not unusual, as many stitches used in such procedures are designed to dissolve or fall out on their own. However, the lack of visible healing and the appearance of the wound you described—looking like "blood flesh"—is concerning. It is crucial to monitor the wound for any signs of infection, such as increased redness, swelling, or discharge. If you notice any of these symptoms, it is imperative to contact your healthcare provider immediately.

Regarding your pain management, it is essential to follow your doctor's recommendations while also advocating for your comfort. If the pain is severe and the prescribed pain medication is not sufficient, do not hesitate to reach out to your physician to discuss alternative pain management strategies. This could include adjusting your current medications or exploring additional options such as topical anesthetics or even nerve blocks in some cases.

You mentioned that you are having difficulty applying the prescribed ointment internally due to pain. This is understandable, and it is important to communicate this to your doctor. They may be able to provide alternative methods for applying the medication or suggest a different formulation that is easier to use. Additionally, keeping the area clean is crucial for preventing infection and promoting healing. If you are unable to clean the internal area as directed, ensure that you are at least maintaining hygiene on the external parts of the wound.

For bowel movements, it is vital to avoid straining, as this can exacerbate pain and hinder healing. You are already using warm water baths, which can help soothe the area. Additionally, consider increasing your fiber intake through diet or supplements to help produce softer stools, making bowel movements less painful. Staying well-hydrated is also essential for preventing constipation.

If you continue to experience significant pain and lack of healing after another week, it is crucial to follow up with your surgeon or healthcare provider. They may want to assess the wound more closely and determine if any additional interventions are necessary, such as a follow-up procedure or a change in your treatment plan.

In summary, while it is normal to experience pain and discomfort after hemorrhoid surgery, persistent severe pain and lack of healing warrant further evaluation. Ensure you maintain open communication with your healthcare provider about your symptoms and concerns, and do not hesitate to seek additional support if needed. Healing takes time, but with proper care and attention, you should see improvement in your condition.

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