Anal Fistula Surgery: Healing Complications and Concerns

Anal fistula

Hello doctor, I had a fistula surgery on January 11 due to an abscess that formed a fistula.
It has been three weeks since the surgery, and I recently noticed that the skin around the surgical site is very thin and painful when pressed.
I felt a hole in that area.
This morning, I woke up to find that the skin over the hole had broken, and there was bleeding and drainage of serous fluid.
The original wound was supposed to heal, but it has reopened.
Is this normal?

Mr. Zhou, 20~29 year old female. Ask Date: 2016/01/31

Dr. Ke Fangxu reply Surgery

The wound from anal fistula surgery typically takes about a month to fully heal.
The current situation likely indicates that the wound has not completely healed, resulting in slight bleeding.
It is recommended to take warm sitz baths and monitor the situation.
If this condition persists for more than two months, it may indicate a recurrence of the fistula.
If medication treatment is ineffective, another surgery may be necessary.

Reply Date: 2016/01/31

More Info

Anal fistula surgery, often performed to treat complications arising from abscesses, can lead to various healing complications and concerns. It is essential to understand the healing process and the potential issues that may arise post-surgery, especially in your case where you are experiencing pain, skin thinning, and the reopening of the wound.

Firstly, it is important to recognize that the healing process after anal fistula surgery can vary significantly among individuals. Factors such as the extent of the fistula, the surgical technique used, the patient's overall health, and adherence to post-operative care can all influence recovery. Generally, the initial healing phase can take several weeks, and during this time, some discomfort and changes in the wound may be expected.

In your situation, the symptoms you describe—thinning skin around the surgical site, increased pain upon pressure, and the formation of a new opening—are concerning and may indicate a few potential complications:
1. Wound Dehiscence: This occurs when the surgical wound reopens, which can happen due to infection, excessive tension on the wound edges, or inadequate healing. The presence of blood and tissue fluid suggests that the wound is not healing as intended.

2. Infection: If the wound is infected, it may lead to increased pain, swelling, and discharge. An infection can also cause the skin around the wound to break down, leading to further complications.

3. Skin Integrity: The thinning of the skin around the surgical site could be due to pressure, infection, or even the healing process itself. It is crucial to protect this area to prevent further breakdown.

4. Fistula Recurrence: In some cases, the original fistula may not be completely resolved, leading to the formation of new openings or the persistence of symptoms.

Given these possibilities, it is essential to seek medical attention promptly. A healthcare professional can assess the wound, determine if there is an infection or other complications, and provide appropriate treatment. This may include:
- Wound Care: Proper cleaning and dressing of the wound to promote healing and prevent infection.

- Antibiotics: If an infection is present, antibiotics may be necessary to treat it.

- Pain Management: Addressing pain through medications or other methods to improve comfort during the healing process.

- Follow-Up Surgery: In some cases, further surgical intervention may be required to address complications or ensure complete healing.

In conclusion, while some discomfort and changes in the surgical site can be expected after anal fistula surgery, the symptoms you are experiencing warrant further evaluation. It is crucial to communicate openly with your healthcare provider about your concerns and follow their recommendations for care. Early intervention can help prevent more serious complications and promote a smoother recovery process.

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