Hey all, haven't been on for awhile. I had surgery June 25 for a fissure and a fistula. The fissurectomy has apparently healed fine, but the fistula is still draining. No blood, just pus and whatever nasty discharge comes with it -- that disgusting fishy-smelling crap. My wife says the hole is smaller and less-inflamed-looking but when I see it in a mirror all I see is red spot that looks angry. I saw my surgeon two days ago and he said there was some 'fibering" (?) I think he said, but he sounded less optimistic than he did during my first follow-up two weeks ago.
Anyway, my BMs are fine, I take stool softeners. My diet has been high-fiber and healthy. I walk twice a day. Pain is minimal except when the pus builds up again then it gets hot and tender. I have been avoiding sitting since the surgery and yesterday was the first time I drove longer than 30 mins since the surgery. It was ok but I do have some pain now and a little more pus than I would like. I try to soak in a hot tub at least twice a day. I am finding that it is starting to get like it was pre-surgery -- pus builds up and I, or my wife, have to end up manually draining the wound, gently of course, but otherwise the pus does not completely drain.
I am very frustrated by the fact that I can go hours without any pain or discharge then I have a BM, no matter how soft, and the pain starts and the discharge begins.
I have been off work for four weeks and I saw my surgeon two days ago and he suggested two more weeks. I am now on a leave of absence after using all my sick and vacation time. I will be going back to work August 12 regardless of what my surgeon says on my next follow-up August 9.
I guess I am wondering if anyone else is having trouble healing? Any tips? I keep hearing soak soak soak but I am beginning to find that hot baths may be irritating me more.
At what stage of the non-healing process does one start considering ostomy bags to stop having BMs so the area can heal without regular inflammation?

Hi did you have surgery to remove the fistula .or just had abscess removed .fistulas take a while to drain .I had an abscess removed.he also put in a Seton drain to drain what was left.2 months later .I had the fistula tract removed .
Did you have the fistula deroofed and all the bad tissue removed .

Hi Hoser,
Yes, fistulae can take a while to drain - longer depending on how bad they were initally and also on their location etc. Some drain for a few weeks, some months, but it would be interesting to know what sort of surgery you had there. The area will be a little uncomfortable after a BM, which is normal but you shouldn't really be getting anything too intense or painful at this stage. I'm baffled by what your CRS mentioned about "fibering"? - I'm wondering if it's related to the scar tissue forming during its healing - Did he appear concerned at all??
It could all be completely normal but sometimes a fistula can heal in the wrong way (it should be healing from the bottom up to fill in the cavity area) which a CRS will look for in their checks. It could also be that the area was not completely drained properly during surgery and this could also prevent the fistula from heaing properly - In my experience, I did get the pus expelling as the wound healed after surgery, but I never had that build up of inflammation and pus release, similarly, to what I had prior to surgery. The wound would just continue to expel pus on & off with no "build-up" afterwards. The pus itself can smell pretty foul but I'd also just check that you don't have any internal/ infection of the wound if you feel it is "red and angry"......
This could all still be normal for you but if you have any concerns, I really would urge you to go back and get it rechecked or a second opinion, especially if the situation is beginning to feel like it was again pre-surgery.
Hot baths are good but I also found ice cold compresses/ cold water really soothing to the area and yes, if you can refrain from putting too much pressure on it, that will also help. Wishing you all the very best with it all........

Thanks. I didn't see a CRS but a General Surgeon with lots of experience with fistulas and fissures.
I appear to be getting slowly better. What I find is that I will feel completely normal in the morning when I get up and first BM and bam the irritation begins. I'm not bleeding but I do have discharge after. It's usually rust coloured. Sometimes I do see white pus oozing out or I have to gently press the area. The area itself is red with white scar tissue at the base. The centre part still looks very red and raw.
What I find works is walking. I am still off work until this Monday so after my morning BM II walk and it really eases the tension of the area. I also get some decent discharge. Same in the evening. I am eating fairly light with softeners yet I do find myself having two to three BMs a day. At the end of the day I am sore and the area is quite tense. I go for a walk and feel great. The muscles loosen I have discharge and I'm good to go again.
I go back to work in four days. Lots of sitting and driving. Any tips? Donut pillow? Soft cushions?
I am trying to just let it be and learn to live with it. Keep it clean etc. is it possible to have such an open wound for months or years even and just live with it? More surgery and time off work is not an option for at least another year unless it becomes an emergency.
Anyone else on week 6 or longer still dealing with an open wound that drains and gets irritated by BMs?
Thanks for your feedback

Hoserbum
I had my surgery jul17 I am dng gr8 no pain I did have pus probably for 8 days now I don't se any.what helped me is sitz bath twice n miralax, Metamucil, colace.i get IMHO g if I walk a lot but heard itching ipmeans healing. Hope u feel better soon u will get thr
Kathy

Hi Hoser,
It's good to read that nothing is worse for you and you feel improvement - It's possible that your fistula was a little nastier than ours I guess and it's just going to take a while longer for you to heal. That would be pretty normal too. As long as you are being taken care of properly and your surgeon is keeping an eye on you, that's the main thing!
It sounds like your healing is taking a while and everything still sounds pretty fresh down there for you, but in time, you won't have that open wound because it will heal over.
My fistula was relatively superficial and small, so healed completely in 8-10 weeks although I still got some internal type healing sensations for a while after that, but at the end of it all, you wouldn't even know I'd had one or surgery for it. There's just no evidence anymore and this should be the case for you too in the long-term (you may get a scar in the area at the worst) As long as the wound is open you might still get that irritation with a BM for a while, but don't worry about the drainage too much - If you read some of the old fistula posts here, some people continued to drain for up to a year, even though they were feeling much better....
It's great that walking helps you too as this will help regulate your BMs and help prevent constipation too as well as keeping you fit and healthy! I found it's a good distraction too........
Going back to work is never easy but the reality is, the thought of it is worse than anything else! I'd just suggest you stay on top of any discomfort with pain killers, use a soft pillow whilst driving and to sit on at work (driving was actually the most uncomfortable thing for me I found) and make sure you pack some wipes to keep yourself feeling clean. I wouldn't necessarily go and buy a donut because I actually found this more uncomfortable!! A soft pillow was by far the most comfortable thing for me.
As long as you are happy you are feeling better and you have every confidence in your surgeon, then I wouldn't start worrying about having to deal with any emergencies because hopefully, you should heal just fine! Just keep the wound area clean & dry to prevent any risk of infection whilst it is still at this stage and you really shouldn't have an open wound anymore within a few weeks.....:) 

Hi All,

I'm facing similar situation. I've had a perianal abscess which was very painful. I was hardly able to walk/sit properly, i.e. reduced to no movement. On the day of the surgery. it burst out on its own but then also I went for the surgery which was alright and the whole area was drained and cleaned. The surgery was done on 18th February, 2016 and the wound almost healed in 8-9 weeks but then I started experiencing pain in the same region after almost 10 weeks of the surgery. There was also a bit of pain and discharge coming through. I went to my CRS again, and after undergoing MRI scan, I was told that it was a low fistula. He further explained that 50% of abscess turn into fistula so that's pretty normal. I just wanted to get rid of all this pain and so I decided to undergo another surgery (called fistulectomy) on 17th May which was less painful than the previous one. The wound has healed properly in about a month and only a small bit is left now. I'm taking sitz baths twice every day and still taking laxative to avoid constipation. I'm also having daily dressings. The healing has been fine until last week and now, I'm experiencing discharge and similar pain (inflammation and needle like pain like before being diagnosed with abscess) after every bowel movement. There isn't any blood in the discharge but there are some stool particles. There are also some brown/yellow coloured stuffs which looks like puss with foul smell. Is that normal or is there any chance that I might have another fistula/abscess? I'm a bit worried as I don't want to go through all of that again. Last 6-7 months have been really painful.
Any help/suggestions/tips is greatly appreciated.
Thanks a lot.