What is the wound supposed to look like?

... And other questions regarding my recent Fistulotomy

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What is the wound supposed to look like?

Postby StudioB » 09 Apr 2022, 15:06

Hi all!
I'm a healthy 34 F living in the north west USA. I've been reading this forum for a bit while I prepared myself for the surgery.

I had a simple anal fistulotomy 5 days ago. It was performed by a very experienced colorectal surgeon. The fistula extended anteriorly less than 1in.

It's since stopped bleeding, and the swelling has gone down, and there's the normal light brown drainage. Which I guess is on track.

But... I have a few questions:

1. They did not send me home with any "packing" instructions that others have mentioned in here. Have others just been left with a gaping wound and no packing?

2. My wound is pretty shallow, but deepest section is at the end farthest from the anus... It looks like a bumpy valley leading to a cave! Is this normal? The only pictures I can find online are horror scenes.

Should I expect that end to close up last? What will it look like if a recurring fistula is imminent?

3. I think they nicked a nerve when the did the lidocaine block... I still have a bit of numbness in my left leg. It's not causing problems walking but it's odd. Anyone else experience this?

Thanks y'all. No matter how common this problem is, I'm still "bummed" it happened at all.
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Re: What is the wound supposed to look like?

Postby James » 11 Apr 2022, 04:39

Hi StudioB,

1.Packing instruction is old school and not neccessery for simple fistula op. Sitz bath and removing hair around the wound is all you need to keep area clean and protect your clothes.

2.Because they mostly lay the fistula open internally into the rectum it means you will have valley inside rather than an external wound - this is what I was expecting and it took me a while to realise that it was done internally.

Try to keep the wound from closing too early by wound digitization with a gloved finger and gently push into the area to prevent pockets of pus from forming. Recurrence is very rare unless underlying issue is causing the fistula.

3.Minor complications are common in any surgery I had contrast media for MRI and ended with pins and needles for a month, but it has now cleared. Just inform them so that they record it on the system incase it doesn't clear.

Good luck with the recovery.
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