Post-Surgery Care for Anal Fistulas
Wound Care (At Home & In Clinic)
Most fistula wounds after surgery are quite manageable at home. The pain from any cuts made during surgery is usually less than when the fistula is in the abscess stage, where the pus accumulates and causes the area to be swollen.
Expect some degree of discharge of fluid or pus from the wound. If the area is quite infected from before surgery, a special dressing may be applied to help with the infection. Otherwise, some will put gauze or wear a pad to help with the discharge.
Most of the time, patients can continue their daily activities. It is important to be able to clean the wound after bowel movements. For lay open fistulotomy, it is important to prevent the wound from closing over any infected tissues, as this could lead to a recurrence of the fistula.
However, the follow up care for each type of surgery can differ. For example, a lay open fistulotomy may require regular wound cleaning and follow up at the clinic. This may be for up to 1-2 months if the wound is very deep. On the other hand, aftercare for the Video-Assisted Anal Fistula Treatment (VAAFT) and Ligation of Intersphincteric Fistula Tract (LIFT) tends to be simpler with just daily cleaning or flushing of the wound with a syringe. In the case of the fibrin glue and fistula plug, minimal wound care is needed.
Lastly, make sure you know when you need to return to the clinic for a follow-up check-up, to ensure that the wound is healing properly.
Post-Op, What Is Normal & What Is Not?
With any open wounds, expect some degree of bleeding or discharge. This gets progressively less until the wound is healed and covered by skin.
Most post-operative care is straightforward. However, please seek medical attention if there is worsening pain, fever, or bleeding that does not stop even after pressing on the wound.
The time taken to heal from a fistula depends on the complexity of the fistula, the degree of infection at the time of surgery and the type of surgery done.