I need your help with regards to recovery after a fistula surgery. I finally removed the packing today and have a look at the wounds. There was a large gapping wound and I got shocked. Is that normal? I dun quite believe that such a large wound will close up by itself?
Doctor asked me to remove the packing today which I did. Then some bright red blood flowed out. I rinse it with running hose and then pat it dry with a clean sponge. Am I doing it right?

Hi Reborn,
Yes, it can be a bit of a shock isn't it?? but that's normal! They come in all sorts of shapes & sizes depending on the original fistula. As it heals, it will start to become a lot less scarey though and the hole will "fill in" gradually. Do you have to continue to pack the wound now or have you been advised to leave it open??
The bright red bleeding is also totally normal! You'll get that for a few days yet, probably less, hopefully. I think I had 3 days of bleeding from the wound but it stopped soon after that. Your cleaning technique sounds just like mine! I used a shower head to clean the whole area and then just patted it dry too with a towel. I just ensured it was constantly clean and dry and don't apply anything topically to the wound because you want the optimum conditions for healing and no risk of infection in there. It takes a little time for the site to heal completely and in my case, the external wound took 2-3 months to heal completely to the point the area looked completely normal again.
Just rest up, keep your BM's soft, try to be patient and you'll get there! Sounds like all is pretty normal at this stage for you.......All the best........

Hi Ever the Optimist,
Thanks for replying. My colorectal surgeon got the entire tract removed. It looks rather short around 1 inch and 4-5 mm thick. I was told that it is very superficial and does not involve any muscle. I can basically feel the tract on my skin tracking towards the anus if I were to squart down.
Yesterday I took out the original bandage and a couple drops of blood dripped out. After that I had my first BM post surgery and wash the area with a water hose. The bleeding seems to stop after that. Right now I am having those clear light pink discharge on that area. Is that normal? I think I will have to get it pack for the next 2-3 days.
The question is, will my anus look like an original anus after getting big hole there? With that big wound, it seems like my anus is getting out of shape. Thanks.

Dear Ever the Optimist,
I need help regards dressing. How long do I need packing before I leave it to heal openly? it is supposed to heal openly from inside out right?

Hi Reborn,
Did you receive any after-care instructions from your CRS after the procedure? Do you have a nurse doing your packing or have you been left to deal with this yourself? I can't really advise you directly on this issue as I don't know the extent of your wound or how long the wound might need packing for. It's really important you go back to your nurse/ CRS to seek their advice on this because I can't advise on this for you.
It is important however, that the wound heals from the inside up towards the outside surface. Some patients are advised to "stretch" the wound out a little to aid the healing process and it should be checked whilst healing just to ensure that it is healing properly. I've attached a really good link for post-operative fistula care, which you may find really helpful.
Your anus will also look like your original anus in time!!
As with all wounds, the fistula will also heal to form a large flat reddish scar and with time, this will settle down and become a more pink colour again in line with the rest of the area. You may or may not notice a permanent scar but it shouldn't be anything too major or horrible. My bottom looks totally normal again today! - You will be fine.
Go back and get some help with your packing for sure but the discharge and everything else you are experiencing right now sounds totally normal!
http://www.stmarksfoundation.org/uploads/docs/patientinformationleaflets/SM07-04%20Anal%20Fistula%20operation.pdf

Dear Ever the Optimist,
Thanks for replying and sharing your experience. I am visiting a company doctor daily to pack up the surgery wound. The doctor will check to make sure that it is healing well.
My healing story on my fistula. I went around searching for non surgery methods to treat my fistula sometime november last year and came across some homeopathic sites. Followed the instructions given by the forum members and started silicea/arnica/ferr phos plus applying antibiotics ointment like bactroban on the lesion. Took sitz bath daily after BM also. The fistula finally reduced in inflammation and I can feel a tiny tube like tract under the skin. I thought it healed and stop sitz bath after bm after using the treatment for 6 months. The lesion immediately flared up after 6 hours. I knew that nothing can treat a fistula except surgery and went for it. My colorectal surgeon took out a fistula tract and show me. It looks like a tiny ginseng root and it is blackish is colour. It looks harden too and I believe that homeopathy medicines are unable to close up the internal opening on that tract which is basically dead tissues.

Ever the Optimist,
I suspect that I have a fistula for many year pior to the infection 2 years ago. I remember having an abscess 15 years ago and another time 10 years ago at the same spot. But it did managed to clear away by itself on those 2 occasions. Maybe it did close temporary and got reactivated 2 years ago which cannot clear up. Have you ever heard of tracts staying inside for many years? My GP doc told me that is quite possible.

Hi Reborn,
That was really interesting reading on your attempts to heal your fistula naturally. I also looked at this but everything led back to the advice that a fistula really only can be healed by surgical intervention, which was why, as soon as I spotted I got one after my abscess, that I resolved to get it sorted without delay. Fistulas can be left for a long time (even by GP's) in the hope that they will heal, but every account I've read has never shown natural successful healing of one of these. They are not life-threatening as such but they're uncomfortable/ prone to further infection and just not nice to have!....Yes, tracts can remain inside for a long time and "reactivate" with infection and it's very possible you have had yours a while. Some of them burrow even deeper creating further complications and surfacing in other areas (sometimes with more than one tract) so in my opinion, if you develop one, just get it sorted as soon as possible!
Same with an abscess - even if you get one that appears and pops without medical intervention, always best get it checked to ensure it's completely drained.
Hopefully, now yours should be sorted too!!

Hi Ever the Optimist,
Thanks for your inputs. I've spent $700-800 bucks on vitamins/oil of oregano/homeopathy medicines. And 6 months of time trying to cure it but disappointed in the end. After 6 months of sitz bath, stop it and 6 hours later it flares up again.
I left it alot because I do recall that I have abscesses around the same area of the anus but it automatically healed previously. I never thought I got a under lying condition below the skin. It looks black in colour so I suspect that it could be a very old tract. But the last abscess wasn't so lucky like the previous ones. It did reactivated the tract and would not close.

Reborn,
It's actually really good in some respects then that everything was "forced" to come to a head and had to be treated in the end. I remember every few weeks once the tract had ended it's pus cycle, thinking, "maybe that's it - it will clear out and go now" but it never did!!....I don't regret the surgery at all and hopefully that's it for you too now. Maybe you can still use all the homeopathic stuff you bought to treat other issues???