Do You Need Stitches Removed After Anal Fistula Surgery?

Is suturing required after anal fistula surgery?

Hello, Dr.
Hsu: I had anal fistula surgery about 10 days ago, and the bleeding has decreased significantly.
Do I need to return for a follow-up appointment to have the stitches removed, or can I wait until the wound heals? Thank you!

Xiao Chen, 30~39 year old female. Ask Date: 2015/12/17

Dr. Xu Kaixi reply Surgery

The wound from anal fistula surgery typically involves absorbable sutures, which will normally dissolve on their own and do not require removal.
However, if there is localized irritation caused by the sutures, a physician may evaluate the situation approximately two weeks later to determine if the sutures should be trimmed.

Reply Date: 2015/12/17

More Info

After undergoing anal fistula surgery, it is common for patients to have questions regarding postoperative care, including whether stitches need to be removed. Generally, the answer depends on the type of sutures used during the surgery.

In many cases, surgeons use absorbable sutures for anal fistula repairs. These sutures are designed to dissolve on their own over time, eliminating the need for a follow-up appointment specifically to remove them. If absorbable sutures were used, you typically do not need to return to the clinic for suture removal, and you can focus on wound care and recovery.

However, if non-absorbable sutures were used, they will need to be removed manually. This is usually done within 1 to 2 weeks after surgery, depending on the surgeon's protocol and the healing process. It is essential to follow your surgeon's specific instructions regarding follow-up appointments and wound care.

Regarding your situation, since you mentioned that it has been about 10 days since your surgery and that bleeding has significantly decreased, it is a positive sign of healing. However, it is crucial to monitor the surgical site for any signs of infection, such as increased redness, swelling, or discharge. If you notice any concerning symptoms, you should contact your healthcare provider promptly.

In addition to monitoring the surgical site, here are some general postoperative care tips for anal fistula surgery:
1. Hygiene: Keep the area clean and dry. Gentle cleansing with warm water after bowel movements can help. Avoid using harsh soaps or scrubbing the area.

2. Diet: A high-fiber diet can help prevent constipation, which is crucial for minimizing strain during bowel movements. Staying hydrated is also important.

3. Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage discomfort. Always follow your surgeon's recommendations regarding medication.

4. Activity Level: Avoid heavy lifting and strenuous activities for a few weeks post-surgery to allow for proper healing.

5. Follow-Up Appointments: Attend any scheduled follow-up appointments to ensure proper healing and to address any concerns with your surgeon.

6. Signs of Complications: Be aware of signs that may indicate complications, such as persistent pain, fever, or unusual discharge from the surgical site. If you experience any of these symptoms, seek medical attention.

In summary, whether you need to return for suture removal after anal fistula surgery depends on the type of sutures used. If you are unsure, it is always best to contact your surgeon's office for clarification. They can provide personalized advice based on your specific situation and ensure that your recovery is progressing as expected. Remember, proper postoperative care is essential for a smooth recovery and to minimize the risk of complications.

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