Managing Post-Surgery Granulation Tissue After Hemorrhoid Surgery

Postoperative wound after hemorrhoid surgery?

Hello, Doctor.
I would like to ask you about a concern.
I underwent a mixed hemorrhoid surgery on August 14, and currently, there is a granulation tissue at one of the wound sites that is slowly growing, now about the size of a red bean.
It is red and sometimes painful, and it bleeds when I apply medication and press on it.
What methods can be used to make it disappear? Is it possible to remove it through an outpatient procedure? How many days would I need to rest afterward, or can I return to work normally? Thank you.

PT, 30~39 year old female. Ask Date: 2013/10/07

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, there may be remnants of external hemorrhoidal tissue that were not completely removed.
If this is the case, it will not disappear but will gradually shrink over time.
As long as there is no pain or bleeding, further treatment is not necessary.
If you wish for it to disappear, excision under local anesthesia in an outpatient setting is indeed a viable option, although not every physician may choose to perform this due to the higher risk of pain and bleeding.
The amount of rest required varies from person to person; however, if your job does not heavily involve physical labor, returning to work should generally be tolerable.

Reply Date: 2013/10/07

More Info

Managing post-surgery granulation tissue after hemorrhoid surgery can be a common concern for patients. Granulation tissue is a normal part of the healing process, but when it becomes excessive, it can lead to discomfort and complications. In your case, it sounds like you have developed a sizable area of granulation tissue that is causing pain and bleeding when irritated.

Firstly, it's important to understand that granulation tissue forms as part of the body's natural healing response. It consists of new connective tissue and microscopic blood vessels that form on the surface of a wound. While some granulation tissue is beneficial, excessive growth can occur, leading to what is often referred to as "proud flesh." This can happen for various reasons, including infection, irritation, or simply the body's healing response being overly vigorous.

In terms of management, there are several approaches you can consider:
1. Observation: If the granulation tissue is not causing significant pain or bleeding, your doctor may recommend simply monitoring it. Sometimes, granulation tissue can resolve on its own as the underlying wound continues to heal.

2. Topical Treatments: There are topical treatments available that can help reduce granulation tissue. These may include corticosteroid creams or other medications that can help to reduce inflammation and promote healing. However, these should only be used under the guidance of your healthcare provider.

3. Surgical Removal: If the granulation tissue is causing significant discomfort or does not respond to conservative measures, surgical excision may be warranted. This can often be done in an outpatient setting, meaning you would not need to stay overnight in the hospital. The recovery time can vary, but many patients are able to return to normal activities, including work, within a few days, depending on the extent of the procedure and their overall health.

4. Follow-Up Care: Regardless of the treatment option you choose, follow-up care is essential. Regular check-ups with your healthcare provider will help ensure that the granulation tissue is healing properly and that no further complications arise.

5. Pain Management: If you are experiencing pain, over-the-counter pain relievers such as acetaminophen or ibuprofen may help alleviate discomfort. However, consult with your doctor before taking any medication, especially if you have other health conditions or are taking other medications.

In conclusion, while granulation tissue is a normal part of the healing process, excessive growth can lead to discomfort and complications. It is essential to discuss your symptoms with your healthcare provider, who can evaluate the granulation tissue and recommend the best course of action. Whether through observation, topical treatments, or surgical intervention, there are effective ways to manage this condition and ensure a smoother recovery from your hemorrhoid surgery. Always prioritize open communication with your healthcare team to address any concerns you may have during your recovery process.

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