How long will it take for fistula surgery to heal

The anus is a very important part of the human body, but some people often suffer from some disease symptoms in the anus, such as anal fistula, which requires surgical treatment. Because anal fistula is a very serious disease, it brings very painful symptoms to people's bodies and also affects people's lives and studies. Therefore, in life, people should always pay attention to protecting their anal area to avoid anal fistula problems. How long will it take for anal fistula to heal after surgery?

Anal fistulotomy is used for the surgical treatment of anal fistula. Anal fistula mainly invades the anal canal and rarely involves the rectum. It is an infectious channel connected to the skin around the anus. The inner opening is located near the tooth line, and the outer opening is located on the skin around the anus. It is a common disease among anal canal and rectal diseases that does not heal for a long time. There are many ways to classify anal fistula, but they are basically based on the location of the anorectal abscess, the course of the fistula and its relationship with the anal sphincter. Currently, anal fistulas are divided into four categories based on the relationship between the fistula and the sphincter.

Postoperative care

The following treatments are done after anal fistula surgery:

1. Change the dressing 24 hours after surgery. For larger wounds, dressing change can be delayed for 48 hours.

2. Check the wound daily to avoid adhesion of the incision edges which may lead to poor drainage. Make sure the granulation tissue on the wound surface grows from the bottom layer to the outside.

3. Dressing change is an important part of the whole process of anal fistula treatment. Correct dressing changes can promote wound growth and accelerate healing, while incorrect dressing changes can delay growth and increase the pain of reoperation. Dressing changes should not be simply understood as changing wound dressings, but more importantly, it is about closely observing changes in the wound and dealing with them in a timely manner. Therefore, the following points should be noted:

① When changing the dressing, the patient should be asked whether he has any subjective symptoms, such as fever, pain, etc., and whether they are related to the wound; the wound should also be considered to determine whether it is consistent. Otherwise, find out the cause and deal with it.

② Pay attention to whether the granulation tissue on the wound surface is growing healthily, whether it is clean and bright red, or purple-red. Whether there is edema, etc.

③ Check whether there is secretion on the wound surface, and observe the consistency and color. Press the area around the wound to see if there is continued secretion.

④ Check whether the skin at the wound edge is turned inward or compresses the wound, causing poor drainage.

⑤ In the middle and late stages of treatment, special attention should be paid to whether there is adhesion and false channel formation in the wound. If there is pitting edema on the wound edge, it is mostly caused by residual ducts or infected suppuration.

⑥ Perform regular rectal digital examination on high anal fistula to understand the growth of granulation tissue at the bottom, drainage, and the tightness of the hanging thread.

⑦ Discover problems and deal with them promptly. If granulation tissue grows too much, it should be cut off in time. If there are residual tracts, infection, or inward rotation of the wound, the wound should be expanded and trimmed in time.

4. To find the internal opening correctly, generally, if there is no bleeding when the probe passes through the internal opening, it proves that the position of the internal opening is accurate.

5. After the elastic band falls off, pay attention to the fact that the wound must start from the base so that the wound inside the anal canal can heal first to prevent the surface skin from adhering and sealing prematurely.

complication

1. Bleeding

Not common. It is often caused by failure to ligate blood vessels in time due to vascular retraction. It can be temporarily packed with gauze and pressure bandaged. If the bleeding still cannot be stopped, surgery is required to stop the bleeding.

2. Anal incontinence

Although rare, it is a serious complication. It is mostly due to the cutting off of the anorectal ring, or partial cutting off, resulting in complete or partial anal incontinence.

3. Anal scar contracture and deformation

This is mainly because the anal fistula wound is large and deep, and too much tissue is removed near the anal margin, causing the wound margin to collapse. After healing, the scar contracts and the anus is deformed. Secondly, after the anococcygeal ligament is cut or the coccyx is removed during surgery, the anus shifts forward, changing the angle between the rectum and the anal canal.

4. The wound grows slowly

If the anal fistula wound is large and deep, it is normal for it to grow slowly. If growth is too slow, consider the following factors:

① The patient has other diseases, such as diabetes, tuberculosis, etc.; ② There are foreign objects left in the wound, such as silk thread, dressings, fish bones, etc.; ③ Improper dressing changes and untimely treatment will cause wound adhesion and false channel formation, and even wound infection.

5. Rectal mucosal prolapse

It is often accompanied by anal incontinence. The two occur for the same reason and should be treated simultaneously if necessary.

6. Urinary retention

In addition to urinary and reproductive system diseases, reactive urinary retention is mainly caused by pain. The anal canal nerves are closely related to the bladder neck nerves. Anal stimulation can often cause spasm of the posterior urethra and bladder neck, which is especially common in cases where an anal tube is placed. As long as the cause of the pain is eliminated, appropriate sedatives can often help urinate. If urination is still not possible, 0.25 mg of carbamylcholine can be injected subcutaneously. Patients who are still unable to urinate 12 hours after surgery require catheterization.