Hi people.
First of all I say sorry for my English.
I'm from Brazil, male, 27 years old. I have found and followed this forum since just before my fistulectomy surgery to try to get some information about recovering. I have noticed that my post op procedures are a bit different from yours.
Well, my excision took out about 4 cm of tissue, thank God no sphincter removal was needed. I'm currently on 11th day post op and here is the summary:
- I'm on painkillers. If I stop it, lots of pain, specially at BM. Speaking of BM, each one causes bleeding and secretion discharge. There is practically no blood discharge if I don't shit (sorry I don't know how to speak). Doctor hasn't prescribed antibiotics. Don't know the reason. Instead of prescribing me stool softeners, he asked the opposite. Yes. I must avoid fibers, the idea is to harden and thicken the stools in order to force the anus to enlarge now that it's healing. He said after surgery, the anus tends to get tightened and this is an invite to new fissures and fistulas. He said I'll suffer a bit now but later I'll be in heaven at BMs. I never read about this before but he's very experienced, thousands of fistulectomys made, I think he knows what he's doing. I wish.
- Doctor told me to wash as much as 8 times a day! I use a hand shower and a mirror to do the job. Once clean, I dress it with a piece of cotton and that's it. About 3 days ago, every time I wake up I have noticed pus discharge. It seems "clear" and not smelling strong. Is this normal?
- since the 2nd day, in the external, visible side of the excision, it has formed a tissue covered with pus. I can see under the pus, the tissue started white but now is getting red and moist. It still has lots of whitish pus covering it. I believe it is a fibrin tissue that is now turning to granulation tissue. I read that in dirty wounds healing by secondary intention, inflammation phase lasts until epithelization completes. Is this right? I hope it is.
Well, that's it. Next week I have an appointment with doctor, he'll check if it's ok.
Cheers.

Hi gui, welcome to the site an I'm sorry you're still having this much continued pain. I can't help you with fissulectomy, but my pain lasted >3 weeks after my fissurectomy, and I ended up needing to get another procedure (2nd Botox injection with debridement). Your instructions from your doctor does sound different from the consensus of what you will read on the site. In my experience, my CRS told me to come off stool softeners, keep with fiber Pills and water when I saw her 1 week after my fissurectomy. Unfortunately, doing that, I retore, badly - in hindsight, i should have stayed on the stool softeners bcz as long as there is an open wound trying to heal, it's too easy to reaggravate the fissure. In your case, it does not make sense to try to "retrain the muscle" by making the poo more firm if the actual fissure hasn't healed yet - this will only lead to more spasms-pain-blood-retear (as in my case).I was in excruciating pain after my fissurectomy more than 3 weeks, and then it was variable - but I learned that I didn't heal correctly and ended up needing a 2nd procedure >3 months after the first. Make sure you ask your doctor all of your questions and don't hesitate to call with questions/concerns between visits. Did you only have a fissulectomy? Or did yOu also have it with an LIS? Good luck with your healing! Keep us posted!

Hi Sailor, thank you for the greetings.
Yeah, it's strange, but maybe it does make sense in my case. In my case, fistulectomy (didn't have LIS), there is a "open" wound, not an incision. There was tissue removal and I won't have a normal skin anymore. I'll have a scar in the place, and that scar hasn't the same elasticity as the normal skin. I think that the hard and large poo will indeed aggravate the wound, but that is the deal now.
Well, sincerely I don't know, I'll have to question the doctor in the next app. Maybe he is using antiquated procedures, and if that's the case I don't know what to do (besides crying lol)
What is driving me crazy is the fact that visually I can't see much improvement since the 2nd day, the wound is ugly, the pain is strong and it's discharging a lot of things, specially in BM.
I'm taking pictures of it, do you like to see? I think I can upload some.
Cheers.

14 days and things doesn't seem good. I can't notice any evolution, instead, now I'm having a greenish pus discharge every morning. Today I have an app with doctor but I think it's time to get worried.
Bad times, I'm having pain in the back and legs caused by the excessive washes with hand shower, the wound does not heal not even a bit and I think I'll lose my job.
I'm getting depressed.

I'm so sorry things aren't improving!! It's so hard to keep your chin up when things don't seem like they are going well. Just wanted you to know I'm thinking about you and praying your doc has good news for you.

Hi friend, your prayer did effect! Thanks a lot!
Returned from doc, he said it's all ok, nothing to worry about, and it's normal, the healing process will be looooong, very long.
The greenish pus coming out every morning is pretty normal as the body is cleaning the area. It is green because of a substance that helps to kill bacteria. It doesn't mean infection. Fever and lots of pain means infection, not pus alone.
I can now decrease a bit the number of washes per day, and he said I can walk, sit, run or even climb a tree if I want, this won't disturb the process. More 15 days and I'll return to work.
He gave me some medicine to speed up healing process, but Im gonna start to take it 45 days from now. He said for now it NEEDS to heal slowly, the outside can't heal before the inside, otherwise this could mean a new surgery. But my inside is better than outside, he said.
Well, thank you, I'll keep the topic updated.
Cheers.