What to do about the false healing of anal fistula?

Written by Chen Tian Jing
Colorectal Surgery
Updated on February 20, 2025
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If a false healing of the wound occurs after local surgical excision of an anal fistula, it is mainly due to improper dressing changes by the patient and a lack of timely observation of the local wound. It is recommended to open the superficially healed wound to allow it to regrow. In particular, the patient needs to change the dressing and observe the wound daily to prevent the situation where the internal part of the wound has not healed, but the external opening appears healed. During dressing changes, hemorrhoid creams and other drugs that promote mucosal healing can also be applied locally and inside the anal canal to further promote the healing of the internal opening. Only when the internal opening has fully grown should treatment that promotes healing of the external opening be applied. (Please use medication under the guidance of a professional physician, and do not self-medicate.)

Other Voices

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Written by Yu Xu Chao
Colorectal Surgery
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Is a second surgery for an anal fistula more difficult than the first one?

Relative to the initial procedure, a second surgery for anal fistula is more difficult. The main goal of anal fistula surgery is to remove the internal opening and the fistula tract completely to cure the condition. During a second surgery for an anal fistula, due to the previous operation, the internal opening may be unclear, and it can be difficult to distinguish between the fistula and scar tissue. This can lead to incomplete removal by less experienced surgeons, increasing the likelihood of the fistula recurring later. Therefore, for a second surgery on an anal fistula, it is essential to undergo the procedure in a specialized colorectal department at a provincial-level top-rated hospital. It is recommended to have a magnetic resonance imaging (MRI) of the anal region before surgery to ensure precise operation and complete removal of the internal opening and fistula tract. Proper postoperative dressing changes are also crucial to avoid infection and inflammation of the wound, which will help with normal recovery after the surgery.

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Written by Chen Tian Jing
Colorectal Surgery
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What are the symptoms of anal fistula?

The clinical symptoms of anal fistula are mainly manifested as intermittent discharge of secretion from the local external opening near the anus, accompanied by varying degrees of pain in the anal area, and occasionally, pus is expelled with the stool. The main reason for its formation is that the anal fistula not only has an external opening, but also an internal opening near the dentate line of the anal canal. The internal opening discharges pus intermittently due to the stimulation of local inflammation. The composition of an anal fistula includes the internal and external openings, as well as the fistula tract that connects them; therefore, simply using medication cannot completely eliminate this lesion. The treatment of anal fistula is mainly surgical, aimed at removing the local lesion, with the principle of preserving the anal sphincter to avoid damage to it, which could affect the patient's future life.

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Written by Deng Heng
Colorectal Surgery
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Does an anal fistula hurt?

The main clinical symptoms of anal fistula mainly include pus discharge, pain, and itching, therefore it definitely causes pain. Usually, anal fistulas do not cause much pain, but when the external opening's drainage is obstructed, pus accumulation can lead to acute episodes, characterized by local swelling and pain, accompanied by significant tenderness. After the pus drains, the pain will decrease, indicating that anal fistulas do cause pain. Other main clinical manifestations of anal fistulas primarily involve pus discharge; that is, there is continuous secretion of small amounts of pus from the external fistula opening, which then causes local moisture around the anus, irritating the skin around the anus and leading to anal itching.

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Written by Chen Tian Jing
Colorectal Surgery
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The difference between perianal abscess and anal fistula

Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.

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Written by Yang Dong
Colorectal Surgery Department
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Consequences of recurrent anal fistulas

If an anal fistula is not treated in time, it may repeatedly occur. If an anal fistula repeatedly occurs, due to local inflammation, pus will spread and infiltrate into the perianal tissues, causing further aggravation of infection. This can then affect the function of the anus, potentially leading to symptoms such as fecal incontinence. Moreover, if an anal fistula repeatedly occurs over a long period, there is a possibility of malignant transformation.