Six months - incision is a non-healing chronic wound

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Six months - incision is a non-healing chronic wound

Postby horsetrainer » 21 Mar 2017, 20:01

Someday I will write in the "fissure success stories" but not yet. I saw my CR surgeon today, who gave me names of five other doctors in the area with whom I may consult if I choose, for a second opinion. The LIS incision developed a fistula after three months, and then he laid that open with a fistulotomy. Three months later, that incision (which is from the original LIS incision) is still open, and still hurts quite badly. He doesn't know why it's still open. The open part is up very high in the anal canal, almost the rectum, so sitz baths don't really touch it. He doesn't want to an advancement flap because he feels the risk of it not healing is high, and then I would be much worse off than I am now. So I'm going to find another CR surgeon to look at me, read my chart, and see if they come to any other conclusion. I don't want more surgery, just want this darn thing to heal, and it is not obliging.
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Re: Six months - incision is a non-healing chronic wound

Postby sandrasmiles7 » 28 Mar 2017, 00:55

Oh my gosh! I have never met anyone else on this site who like myself had LIS surgery and is still not healed. I had my surgery in October now in March the fissure probably healed but the incision site itches and opens every day. Please keep me updated
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Re: Six months - incision is a non-healing chronic wound

Postby horsetrainer » 28 Mar 2017, 09:04

We're among the lucky few, I guess! I went to get a second opinion, and the new CR surgeon said it's basically just bad luck. He said he does lots of LIS and at one month about half of the patients are healed, and at two months he expects all of them to be healed. I asked if he'd seen this before (as my first dr had never had this happen) and he said "a few". And that it will eventually heal, but no guess as to the timeline. This new doctor suggested that I stop having silver nitrate applied, which my current surgeon had been doing every couple of weeks, and go back to the Operating room for probing of the wound for possible fistula, and debridement of the wound. I plan to call my first CR surgeon today and ask him if he'll do this. I really like my original doctor and want to stick with him - he is smart and kind and really wants to help me.

I had already developed a small fistula in the wound four months ago, which the surgeon opened up. It's possible that it has become infected again. I have drainage of a yellow-green color pretty much constantly. It might be from the wound trying to close itself or it might be pus, it's hard to tell.

There are times I feel very depressed about living with this painful wound, but I'm trying to just take it one day at a time. Someday it will heal, and I'm trying to make the best of it.
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Re: Six months - incision is a non-healing chronic wound

Postby sandrasmiles7 » 29 Mar 2017, 00:43

How did you figure out you had a fistula? Did the doctor tell by looking? I wouldn't mind amother surgery if things would get healed but my surgery for the LIS was like $2000. And I'm guessing something else would be very pricy. I don't really have pain just the healing itch all the time. Do you have less pain than the original fissure that you had?
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Re: Six months - incision is a non-healing chronic wound

Postby horsetrainer » 29 Mar 2017, 16:47

The surgeon found the fistula only by exam under anesthesia. At the time, he had me consent to a couple different procedures in case he found a fistula when he examined me. He found that behind the incision was a short, dead-end tract that he opened up surgically. That was four months ago, and it is still open and oozing. I do believe that it is healing, they call this "healing by secondary intention" as the wound lays down one layer of cells at a time, and it can take months.

The pain from this wound is worse than the original fissure pain. My fissure was anterior and I'd had it for years. I'm glad to say that the LIS helped the fissure to heal, and it doesn't hurt at all. It's unfortunate that I traded one thing for another. But given the information I had, I would make the same choice again. The doctor said that it is just bad luck.
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Re: Six months - incision is a non-healing chronic wound

Postby missy moo » 27 May 2017, 20:28

Have you guys healed yet? Hope all is well
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Re: Six months - incision is a non-healing chronic wound

Postby horsetrainer » 27 May 2017, 23:26

I just had another appointment with my colorectal surgeon a few days ago. My LIS incision is still open. During the last ten months, the doctor has applied silver nitrate twice and has done two debridements under anesthesia. The wound is about one centimeter long. It oozes gunky stuff, and when I have a BM I have to gently clean inside it with my finger and vanicream lotion (which is the best lotion out there, I am sensitive to many ingredients).

I told my surgeon that I don't have much hope that it will ever heal.

It causes high rectal aching in my pelvic floor in addition to the burning pain of the skin of the anal canal. It's high, and can't be seen from the outside; it's almost in the recturm.

The doctor prescribed pelvic floor physical therapy, and I met with the PT this week. I feel let down by the system and my body, though, and I don't really want to have another clinician looking at my butt and touching me. When my surgeon told me that he's "confident" that physical therapy will help my pain, I started to cry. He told me to do the PT and then come back in two to three months. I usually love my CR surgeon but in that moment I felt a new emotion toward him, which was rage. Most of it is misdirected, but it's such a debilitating thing to have this wound.

I cope with this miserable condition by trying to stay in the moment: I love the outdoors, gardening, my horses, and my dogs. I have a wonderful family. I am beginning to ride again and it seems that riding is not as painful as walking. I try to remind myself that there are many things to be grateful for, but I have my moments of rage and depression.
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Re: Six months - incision is a non-healing chronic wound

Postby missy moo » 27 May 2017, 23:38

Wow I still have a fissure coming up 4 years an I'm considering lis hearing your story makes me realise anything can happen but i know your outcome is very rear? God bless you maybe in time you will look back at this with no pain or discomfort a d completely healed I really wonder why it hasn't healed do you mind telling me your gender age and any other health issues?
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Re: Six months - incision is a non-healing chronic wound

Postby horsetrainer » 28 May 2017, 12:22

It is very rare to have the LIS incision not heal. It is generally well-tolerated and usually is a great success. I'm 46 years old and female. I had sexual anal trauma as a child and it's possible that my anus is more prone to chronic wounds. That's just a theory of mine, the doctors don't know why or really what else to do.
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Re: Six months - incision is a non-healing chronic wound

Postby missy moo » 28 May 2017, 17:02

Im so sorry you had this childhood issue have you had a mind body soul healing type of thing you mite be having a harder then normal time healing due to your mind trauma and the anus association. and also given your age have you consider low estrogen it causes skin to dry an wounds to have poor healing you can get estrogen cream to put on affected areas or estrogen supplements ie pills or birth control pills you could ask your doctor
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