Dressing up tips... please contribute :)

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Dressing up tips... please contribute :)

Postby BlackStallion » 30 Jun 2013, 10:49

WE all dress for the occasion, dressing up right after a fistula op is important I think to avoid infection and aide healing!!! I am sure you will agree :)
After my 3rd op, I had the district nurse making house call for the first week.. after which I was mobile enough to drive down to my GP. During the first week, and the first few days more so.. were painful. Trying to schedule the dressing and visit to the loo was a nightmare. I wanted to make sure I could go to the loo have my clean up routine of shower head hosing down and bath before the nice lady district nurse came along. Which was around 10:00 in the morning. The first couple of days ... where a combination of anaesthesia after effects and tramadol's were dulling me down, it was a bit of a task to be up and give enough time for the loo and clean up.
Anyway.. I found the dressing up a fistula was differently done by different nurses. Some just rolled up a sheet of kaltostat and wedged it in. Some used the soft fibrous kaltostat and packed it in the open fistula track. Some used Acqacel, which is pretty stiff strip, goes in the cut like a stiff lolly stick!! and then restricts movement for quite some time.
Keeping in mind that pus and a very little blood is still seen on the swabs, should I still pack my fistula track? The pus is thick.. yellow/greenish and stinks!! Should I ask for antibiotics..? Pain.. its there.. but nothing out of the ordinary or excruciating. But its there.. its a constant.
please feel free to type your questions / suggestions / recommendations... hopefully I will have some peace of mind.. If I am doing the right things.. and change my routine if I am missing is anything..
May god us give us all strength to see the "back" of this ... soon!
BlackStallion
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Re: Dressing up tips... please contribute :)

Postby Ever the Optimist » 04 Jul 2013, 14:22

Hi Blackstallion,
I'd definitely get a second opinion on that pus as anything of that description could imply an infection??? I would definitely check to see if that is "normal"??
I don't know how bad your original fistula was so could be it was deeper and nastier than my fairly superficial one and is expelling a lot more pus but my pus was never as you describe, which is why I would go back and check......I can't advise you on the packing as my CRS felt mine was better left "open" to heal, so I didn't get that packing issue. My tips would be 1) definitely get it checked over by your nurse/ CRS and get checked for infection (Yes, they will possibly administer you anti-biotics if this is the case) and ask whether you actually need the packing. If you can get away without it, that would make your life a lot easier.
2) Ensure you thoroughly clean the area gently with a hand held shower (if you can) as this also "stretches" the wound a little too.
3) Don't put anything on it externally (creams etc...) It needs to remain clean & dry.
If you're still within a 3-6 month time frame of your surgery, pain will be normal (sorry!) but it should decrease over that period as the wound starts to heal and drainage reduce. Continue to ensure you are maintaining the softest stools possible with no straining, to eliminate any additional pressure in that area through a good fibrous diet and lots of fluids too - If you can get out and walk a little, that's also very helpful.....Do get it checked out again though & wishing you well! Fistulas are pests but they do heal pretty well and recovery is normally extremely successful.
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Dressing up tips... please contribute :)

Postby BlackStallion » 05 Jul 2013, 14:04

OK... the pus I will have that checked out. The problem is that I clean up my wound and put in a fresh swab before I see the dressing nurse / crs. What they see has been recently cleaned up... but that is not really the case.. it accumulates in hours. Thanks for your suggestions optimist..I will take them all. :)
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Re: Dressing up tips... please contribute :)

Postby Ever the Optimist » 07 Jul 2013, 14:27

Yes - better to be safe than sorry!
It may well be normal, some fistulas have a lot of pus to expel! - but could be good if they get to see it at its worst (yuck - I know!!) Keep updating :) 
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Posts: 1625
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Joined: 12 Apr 2012, 16:00
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Has thanked: 62 times
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