How to cure severe fistula. Postoperative fistula and its treatment. Treatment methods for postoperative fistulas

Hello, Vladimir!

Postoperative fistulas are different and therefore their treatment tactics are also different.

Therefore, you just need to contact your doctor so that they can take appropriate measures. In the hospital, doctors must first of all clarify the length of the fistula tract. This can be done using probing and fistulography. To find out how the postoperative fistula is connected to the surrounding organs, it is necessary to inject a special dye into it.

In the end, you can simply invite a surgeon to your home if you cannot bring your wife to the hospital. There is no need to self-medicate a fistula. Fistulas are quite common, but they are a very serious complication, often requiring repeated surgery, so you should not hesitate to visit a surgeon.

Postoperative fistula and its treatment

Treatment of fistula depends on its type:

for labiform fistulas conservative treatment will not have results, so you need to resort to surgery;

a tubular fistula can sometimes close on its own, but this happens if the contents cease to be released from it;

pancreatic fistulas often close after radiotherapy;

with purulent fistulas, the patient needs to remove foreign bodies that support the inflammatory process.

As you can see, a fistula after surgery is treated based on its type. The sooner a fistula is detected, the sooner all examinations can be carried out and treatment can begin. Therefore, go to the hospital immediately.

Treatment of fistula with folk remedies

Fistula can also be treated with traditional methods, but the best option is to combine traditional medicine with the recommendations of the attending physician.

Mix olive oil and vodka equally and rub the resulting emulsion on the problem area up to three times a day.

It is also recommended to attach cabbage leaf to the fistula with the outer side. In half a month a positive result will appear.

Mumiyo is diluted in water and mixed with fresh aloe juice. The ointment is applied to a bandage and applied to the navel or other problem area.

When a fistula remains after surgery, take three tablespoons of St. John's wort, boil a little in 300 ml of water, and then filter. The still hot grass is laid out on parchment, they undress and sit on it.

The temperature must be endured, without, of course, causing a burn. After the compress has cooled, you also need to wash yourself with the herbs. The procedure is carried out until the pus is completely released, plus a couple of control procedures to consolidate the result.

Cut twelve leaves from an aloe (at least two years old), wash, finely chop and place in liter jar. Add honey there. Infuse, stirring in the dark. After a week, strain and take a teaspoon three times a day before meals.

Tinctures for the treatment of fistula

The fistula is washed with furatsilin solution from a syringe or small syringe.

A miraculous ointment for fistulas in the rectum and vagina is prepared from oak bark, toadflax flowers, water pepper herb and lard.

All vegetable raw materials are crushed, poured with melted lard (1:2) and placed in the oven on low heat, where it simmers for half a day. You apply tampons with ointment to the sore spots.

Good results are noticeable from the use of oil extracts of marsh cudweed. There is also pharmaceutical drug— alcohol-oil extract of cucumber.

Chamomile infusions and decoctions are used externally to wash fistulas. A tablespoon of flowers is brewed with a glass of boiling water and filtered after an hour.

From the infusion of calendula flowers, washes, compresses and baths for fistulas are prepared; for this, a teaspoon of flowers is brewed with a glass of boiling water, and after an hour it is filtered.

Fistula after surgery is always a postoperative complication. The fistula occurs as a result of suppuration and infiltration of the scar. Let's consider the main causes of fistula, its manifestations, complications and methods of treatment.

What is a fistula

A ligature is a thread used to ligate blood vessels during surgery. Some patients are surprised by the name of the disease: they think that the wound after surgery may whistle. In fact, a fistula occurs due to suppuration of the thread. A ligature suture is always necessary; without it, wound healing and bleeding cannot be stopped, which always occurs as a result of surgery. Without surgical thread, it is impossible to achieve wound healing.

Ligature fistula is the most common complication after operation. Looks like a normal wound. It means an inflammatory process that develops at the site of the suture. An obligatory factor in the development of a fistula is suppuration of the suture as a result of contamination pathogenic bacteria threads A granuloma, that is, a compaction, appears around such a place. The compaction contains the festering thread itself, damaged cells, macrophages, fibroblasts, fibrous fragments, plasma cells, and collagen fibers. The progressive development of suppuration ultimately leads to the development of an abscess.

Reasons for formation

As already mentioned, it is the festering suture that contributes to the progression of the purulent process. A fistula always forms where there is a surgical thread. As a rule, recognizing such a disease is not difficult.

Often fistulas occur as a result of the use of silk thread. main reason This phenomenon is infection of the thread by bacteria. Sometimes it is not large and goes away quickly. Sometimes a fistula occurs several months after the intervention. In the rarest cases, the fistula appeared even after years. Most often they occur after operations on the abdominal organs. If a fistula occurs at the site of the surgical wound, this indicates that an inflammatory process is taking place in the body.

If during surgery the body enters foreign body, this causes the wound to become infected. The reason for this inflammation is a disruption in the processes of removing purulent contents from the fistula canal due to large quantity liquids. If in open wound infection gets in, this can be an additional danger, as it contributes to the formation of a fistula.

When a foreign body enters the human body, the immune system begins to weaken. Thus, the body resists viruses longer. Long stay foreign body and causes suppuration and subsequent release of pus from postoperative cavity out. Infection of the ligature thread often contributes to the formation of a large amount of pus in the postoperative cavity.

Main symptoms

A fistula at the suture has the following severe symptoms:

Diagnosis and treatment

The correct diagnosis can be made by a surgeon only after full diagnostics. It includes the following measures:

1. Primary medical examination. During such actions, the fistula canal is assessed and the granulomatous formation is palpated.
2. Study of patient complaints. A thorough examination of the medical history takes place.
3. Sounding of the canal (to assess its size and depth).
4. Examination of the fistula canal using x-rays, ultrasound, dyes.

All patients should remember that treating fistula with folk remedies is strictly prohibited. It is not only useless, but also life-threatening. Treatment of the disease takes place only in a clinic setting. Before treating a fistula, the doctor conducts a detailed diagnostic examination. It helps to establish the extent of the fistulous lesion and its causes. The main principles of therapy are the removal of the festering ligature. It is necessary to take a course of anti-inflammatory drugs and antibiotics.

It is necessary to strengthen the immune system. Strong the immune system- This is the key to recovery from many pathologies. Elimination of formation is impossible without regular sanitation of the cavity. A solution of furacillin or hydrogen peroxide is used as a rinsing liquid; they remove pus and disinfect the edges of the wound. Antibacterial agent should be administered only as directed by a doctor.

In case of ineffective treatment of the fistula, surgery is indicated. It involves removing ligatures, scraping, and cauterization. The most gentle way to remove suppurating ligatures is under the influence of ultrasound. With timely and quality treatment the likelihood of fistula complications is minimal. Emergence inflammatory reactions in other tissues human body minimal.

In some cases, a postoperative fistula can be created artificially. So, for example, it can be created for artificial feeding or excretion of feces.

How to get rid of a fistula?

There is no need to wait for healing to occur. Lack of treatment can provoke increased suppuration and its spread throughout the body. The doctor can use the following techniques and stages of fistula removal:

• cutting tissue in the affected area to remove pus;
• excision of the fistula, cleaning the wound from pus and its subsequent washing;
• removal of suture material blindly (if possible);
• if it is impossible to remove the suture material blindly, the doctor makes a second attempt (further dissection of the zone is carried out last, since this measure can provoke further infection);
• the ligature can be removed using special instruments (this is done through the fistula channel without additional dissection, which reduces the risk of further secondary infection);
• Surgical treatment of the wound is performed (in case of unsuccessful removal of the fistula canal, the wound is treated with an antiseptic).

If the patient strong immunity, then the fistula can heal quickly, and no inflammatory complications are observed. It can self-destruct very quickly in rare cases. Only with an inflammatory process of minor intensity, the patient is prescribed conservative treatment. Surgical removal of the fistula is indicated when a large number of fistulas appear, as well as if the leakage of pus occurs very intensely.

Remember that a healing antiseptic only temporarily stops inflammation. To permanently cure a fistula, you need to remove the ligature. If the fistula is not removed in time, this leads to a chronic course of the pathological process.

Why are bronchial fistulas dangerous?

Bronchial fistula is a pathological condition of the bronchial tree, in which it communicates with external environment, pleura or internal organs. They occur in the postoperative period as a consequence of bronchial stump failure and necrosis. The specified type of bronchial fistula is common consequence pneumonectomies due to lung cancer, other resections.

General symptoms of bronchial fistula are:

If water gets into such a hole, the person experiences a sharp paroxysmal cough and suffocation. Removal of the pressure bandage provokes the appearance of the above symptoms, including loss of voice. Dry barking cough– Sometimes a small amount of viscous sputum may be coughed up.

If the fistula develops against the background of purulent inflammation of the pleura, then other symptoms come first: secretion of mucus with pus, with unpleasant foul odor, pronounced suffocation. Air is released from the drain. Subcutaneous emphysema may develop. Complications may include hemoptysis, bleeding from the lung, or aspiration pneumonia.

The connection of the bronchus with other organs causes the following symptoms:

• coughing up food or stomach contents;
• cough;
• asphyxia.

The danger of bronchial fistulas refers to a high risk of complications, including pneumonia, blood poisoning, internal bleeding, amyloidosis.

Genitourinary and intestinal fistulas

Urogenital fistula appears as a complication of genital surgery. The most common communications are between the urethra and the vagina, the vagina and the bladder.

The symptoms of genitourinary fistulas are very clear, and it is unlikely that a woman will fail to detect them. As the disease develops, urine is released from the genital tract. Moreover, urine can be released either immediately after urination or all the time through the vagina. In the latter case, a person does not experience voluntary urination. If a unilateral fistula is formed, then women most often experience urinary incontinence, but voluntary urination persists.

Patients feel severe discomfort in the genital area. During active movements such discomfort intensifies even more. Sexual intercourse becomes almost completely impossible. Due to the fact that urine is constantly and uncontrollably released from the vagina, a persistent and unpleasant odor emanates from patients.

Postoperative rectal fistulas are also possible. The patient is concerned about the presence of a wound in the anal area and the discharge of pus from it, sanguineous fluid. When the outlet is blocked by pus, there is a significant increase in inflammatory process. During increased inflammation, patients complain of severe pain, sometimes making movement difficult.

The fistula seriously worsens the general condition of the patient. Long-term inflammation disrupts sleep and appetite, a person’s performance decreases, and weight decreases. Due to inflammatory phenomena, deformation of the anus may occur. The long course of the pathological process can contribute to the transition of the fistula to malignant tumor- cancer.

Disease Prevention

Preventing the development of a fistula depends not on the patient, but on the doctor who performed the operation. The most important preventive measure is strict adherence to the rules of disinfection during the operation. The material must be sterile. Before suturing, the wound is always washed with an aseptic solution.

A fistula is a kind of abscess or abscess, which is characterized by a limited accumulation of pus in muscle tissue or in any organ of the body. Manifestation on the body, ulcers, boils, phlegmon, lymphadenitis, purulent pleurisy lungs, peritonitis and progressive thrombophlebitis. The causes of such abscesses are most often Pseudomonas aeruginosa. Treatment recommendations vary depending on the complexity of the disease. Typically, a combination of drug treatment is used, which is prescribed by a doctor, plus the use of herbal medicine.

How to heal a fistula with folk remedies?

If you decide to use only traditional medicine recipes, and not use medications prescribed by a doctor, you can try to cure a fistula with cakes made from comfrey root powder with the addition of honey. To heal a fistula, you will need a tablespoon of honey to prepare it, grind it with a tablespoon of comfrey powder, make a cake from the mixture and apply it to the purulent wound overnight. Place cellophane on top of the cake and cover with a woolen bandage. In the morning, rinse everything off with warm saline solution. The beauty of comfrey is that it promotes tissue renewal and stimulates the growth of healthy cells.

Another great recipe that will help treat abscesses and fistulas. Take 12 leaves of an aloe flower; the plant must be at least two years old. Rinse the leaves with boiled water. Chop them finely and put them in a liter jar, pour honey into it. Place in a dark place and let it steep. It is necessary to stir the mixture once a day. After 8 days, the infusion must be filtered several times and drunk a teaspoon before meals, three times a day.

Folk recipes for remedies for ulcers, abscesses and fistulas

Try this set of herbs: calendula officinalis (flowers) – 15 g; large plantain (leaf) – 15 g; chamomile (flowers) – 10 g; Salvia officinalis (herb) – 15 g; St. John's wort (herb) – 20 g; elecampane (root) – 15 g; horsetail (herb) – 10 g.

1 tbsp. l. with a small heap (5-8 g) of the collection is poured into 1 glass (200 ml) boiled water, cover with a lid and heat in a boiling water bath for 15 minutes ( herbal infusion should not boil), cool at room temperature for 45 minutes, filter, squeeze out the remains. The volume of the resulting broth is added with boiled water to the original volume. Take 1/3-1/2 cup of infusion or decoction 3 times a day before meals for pustular skin diseases.

For poultices, the following collection is used as an emollient for skin ulcers: chamomile (flowers) – 35 g; sweet clover (herb) – 35 g; Marshmallow officinalis (leaves) – 30 g. Brew with boiling water to a paste-like mass, wrap in a cloth and apply hot to the sore spot as an emollient. To prepare compresses and baths for abscesses use: common oak (bark) – 50 g; Calamus (rhizome) – 50 g. Use at the rate of 2 tbsp. l. per 200 ml of water in the form of an infusion for preparing compresses and baths for ulcers, abscesses and other skin diseases.

How to treat a fistula or abscess with ointment?

In order to heal fistulas, you can use ointments that are sold in pharmacies. This is the ointment of Vishnevsky, Ichthyol, the Balynin sisters and many others. To prepare such an ointment you will need 100 ml of church oil, which can be bought at any church store, add 40 g beeswax, then put the mixture on low heat. Add 1/3 teaspoon of granulated sugar. Heat until everything is dissolved, after which you can remove the mixture from the heat and leave to cool. Place the finished, cooled ointment in a dark glass jar and store it in the refrigerator. Shelf life is no more than a year. Apply a thin layer of ointment to the area of ​​the abscess and apply a bandage on top that is not too tight, but secure it well. The bandage should be changed 2 or 3 times a day, depending on the abscess.

How to treat an open abscess or fistula?

If the fistula has access to the surface of the skin, then an effective treatment for the fistula is to “soak” it in hot and salty water. For this you will need 2 teaspoons of salt. Do brine and keep the affected area in it. The first sensations you will feel immediately are the wound will begin to twitch, after which you will, on the contrary, feel significant relief. Thanks to this method, you can quickly clean an open abscess that for a long time could not break through and completely come out.

Another method of treatment is mumiyo and honey. You need to grind 3g mummy and mix it with a teaspoon of honey. Make a cake from the resulting mixture and apply it to the abscess. The abscess will burst and quickly clear, the wound will begin to heal. Such cakes need to be changed strictly once a day, while the wound is washed with hydrogen peroxide and dried with a gauze cloth.

A good practice for treating a fistula is to rinse it with furatsilin solution. To prevent a boil from forming in a new place in a couple of days, strengthen your immunity.

In the summer I was crossing the road along the tram tracks, I hurried, tripped and fell. The rails lie on a broken-down road, so when I fell, I felt that I had plowed through all the potholes and holes with my body. I stood up with difficulty, it seemed to me that my brains had just been knocked out. I was actually going to the store, so I got up and moved on. But after just a few steps it began to hurt me to walk. I looked down and saw that my trousers were torn on my right knee, and there was blood all over my knee. I immediately went home. The right arm was skinned, the skin on the elbow was completely gone, and the blood was not flowing as much. When I came home and took off my pants, it turned out that in just five minutes my knee had swollen and became the size of three knees. She was all smeared with road dirt, dust and blood. I was even scared. Moreover, I always run into something with my feet. As a child, I climbed onto the roof of the stable, wanted to look at the horses, and fell. I didn’t hurt myself, but I ran into some kind of rod sticking out of the ground and pierced my knee. The same one, right. Then, too, blood gushed out.

I got into the bath, washed my knee and arm, which was already hurting unbearably, and then immediately poured hydrogen peroxide on it, clenching my teeth. The pain went all the way down to the point where I wanted to howl. I was even afraid that I might have crushed my kneecap, but under such a huge tumor it was not visible. I went into the room and lay down on the sofa, but as soon as I sat down, pain pierced my back. I jumped up, looked, and didn’t see anything. I returned to the bathroom and there in the mirror I saw that the skin from the back of my shoulder and along my shoulder blade had been torn off, in some places I could see bare flesh, well covered with dirt. I got into the shower again, washed it off as best I could, and discovered that I had run out of peroxide. But you can’t treat an abscess with alcohol; you’ll burn the tissue. While I called my mother, while she brought me peroxide on her way back from work, the infection had already taken root. Soon it began to fester in some places. Only on the shoulder and shoulder blade, everything was fine with the knee. Then an abscess appeared on my shoulder blade. My skin on my back isn’t so great after acne, I still don’t have enough abscesses! My mother and I began to treat these abscesses together as best we could.

I put on compresses for the treatment of abscesses at night from a decoction of willow bark to treat abscesses: I soaked a cloth, applied it and covered it with paper, then bandaged it. I applied a mixture of 20 g of mint, 20 g of caraway seeds and a tablespoon of rye flour, crushed verbena roots, and coltsfoot compresses.

I tried to treat abscesses from the outside and from the inside. I drank fresh yarrow juice with honey, ate foods that help treat abscesses - beans, broccoli. In a word, she did everything possible to heal the abscess. And the skin healed! After about three days the pain began to decrease, after five days the pus disappeared, the wounds stopped festering, and then began to heal, and new skin began to grow. By the way, I did the same thing on my knee, only less often. It took much longer to heal, even though there was no abscess on it - apparently, it was really a very severe bruise. I still have a scar on my entire knee, in addition to the one I got as a child. And there is also a scar on my elbow from that fall. My skin recovers so poorly. One consolation: now in beauty salons people get scars for money, this fashion is gradually spreading, like with tattoos. If it spreads completely, I will be very fashionable! You have to find at least some positive in everything, even in the treatment of abscesses and fistulas!

Chistyakova Raisa Pavlovna

Rectal fistula (medical name - fistula) is a through tubular canal that connects the abdominal organs. The inside of the fistula is lined with epithelial cells or “young” connective fibers, formed as a result of the tightening and healing of various wounds and local tissue defects. About 70% of rectal fistulas form in the pararectal space and extend from the morganian crypts (pockets open to the movement of feces) to the skin. Anorectal fistulas come from anus directly to the skin.

Treatment of rectal fistulas usually involves the use of surgical methods, as well as mechanical and chemical cleaning of the cavity. Very often, patients who have been diagnosed with purulent fistulas of the rectum are interested in whether the fistula can be cured without surgery. Experts agree that treating pathology with medications and folk methods is ineffective and can only be used as an auxiliary component to accelerate regenerative processes and quickly restore damaged tissue. There are also methods that allow excision of a fistula without surgical (invasive) intervention, so the patient must know complete information about everyone available methods therapy.

Most proctological surgeons believe surgery the most effective method of treating various fistulas, since during surgery the doctor can remove all damaged tissue, which significantly reduces the risk of relapse. Excision of fistulas using a scalpel is an invasive, highly traumatic operation that requires long-term recovery period, so many patients are looking for ways to treat fistulas without surgery. About them and we'll talk below.

Laser treatment without surgery

This is one of the safest, most effective and least traumatic methods of treating fistula tracts, which has several advantages. Laser treatment, if indicated, can be carried out even in children and adolescents, although some doctors do not recommend using this technique in children under 10 years of age. Impact laser beams does not cause discomfort and painful sensations, and after the procedure there is no need for a rehabilitation period. After excision of the fistula with a laser, there are no scars or scars left on the skin, which is important if the operation is performed in the anorectal area.

Despite the large number of advantages, laser treatment also has significant disadvantages, including:

• high cost (in different clinics the cost can vary from 20,000 to 45,000 rubles);
• a fairly high probability of relapses and complications (about 11.2%);
• side effects in the form of anal itching and burning at the site of excision of the fistula;
• impossibility of use for purulent fistulas.

Note! Laser excision of fistula tracts is practiced in all private clinics in large cities, so there are usually no problems finding a laser proctologist surgeon.

Radio wave therapy

More in a modern way Removal of rectal fistulas is radio wave therapy. The method is suitable for the treatment of all types of fistulas, and its main advantage is the absence of the need to go to the hospital. The patient can go home within 10-20 minutes after the procedure, since it does not require general anesthesia: the doctor performs all actions under local anesthesia(traditionally Lidocaine or Ultracaine is used).

Complete healing and tissue restoration after radio wave excision of a fistula occurs within 48 hours, so if the fistula was removed on Friday, the patient can go to work on Monday (the standard recovery period after surgery is at least 14 days). To determine the most suitable treatment method for himself, the patient can use the comparative characteristics given in the table below.

Table. Comparative characteristics various methods treatment of rectal fistulas.

Options	Laser treatment	Radio wave therapy	Surgical excision using a scalpel
Need for hospitalization	Usually not required (in some cases, the doctor may recommend observation for 1-2 days).	Not required. The patient can leave the clinic 20 minutes after the procedure.	The patient must be hospitalized in a hospital 2-3 days before the scheduled operation. After excision, the patient remains in the hospital for about 2-3 weeks.
Use of general anesthesia	Not required.	Not required.	Depending on the shape of the fistula and the extent of tissue damage, general anesthesia may be required.
Scars and scars after surgery	The probability is less than 5%.	The probability is less than 1%.	The probability is more than 92%.
Postoperative pain	None.	None.	They may bother you for several months, especially if the patient has a tendency to have stool disorders.
Healing and recovery period	From 2 to 5 days.	48 hours.	Three weeks.
Probability of relapses and complications	About 11.2%.	Practically absent.	Complications may occur.
Price	20-45 thousand rubles.	14,000 rubles.	It is carried out free of charge under the compulsory medical insurance policy.

Important! Despite all the advantages non-invasive methods treatment of perirectal fistulas (without a scalpel), the final decision on the possibility of using these techniques should be made by the doctor, based on the degree and severity of the lesion and general condition sick.

Treatment of rectal fistulas with traditional methods

When choosing the most appropriate treatment method, patients should understand that effective way The only treatment for anorectal and pararectal fistulas is surgical therapy. Traditional methods can be used as aid, which relieves inflammation, draws out pus and ensures the outflow of exudate. Some components effectively eliminate pain and accelerate tissue healing, but complete recovery after using even the most effective recipes impossible. This is due to the anatomical features of the structure of the fistula tracts, therefore the recipes given below are recommended to be used only as an auxiliary therapy after consultation with a doctor.

Honey ointment

Natural honey is one of the most effective anti-inflammatory remedies in traditional medicine. Honey and bee products (propolis, bee bread, royal jelly) contain more than 20 components that soothe the skin, relieve inflammation and stimulate tissue regeneration.

To prepare it, you need:

• Mix 5 tablespoons of liquid honey with two tablespoons of melted honey butter(use only natural butter made from pasteurized cow cream);
• add 15 drops of fir oil to the mixture;
• heat in a water bath until boiling and remove from heat;
• put in the refrigerator for 8 hours.

The resulting ointment must be lubricated with the affected area (you can use a tampon) 5-6 times a day. Treatment should be continued for 3-4 weeks.

Herbal ointment with lard

Recipes based on lard are used for fistulas accompanied by the formation of purulent exudate. Mixture medicinal herbs disinfects the skin, prevents ascending infection of the rectum and soothes inflamed tissue, accelerating healing and tissue restoration. To prepare the ointment you need:

• in a deep bowl, mix 1 teaspoon each of oak bark, chamomile and water pepper herb;
• add 300 ml of water and put on low heat for 20 minutes;
• Cool the broth and strain, then add 4 tablespoons of melted lard to it;
• mix everything and put it in the refrigerator to harden.

If the finished ointment is very liquid, you can add 1-2 tablespoons of butter, previously crushed using a fine grater, and then put the product back in the refrigerator. The ointment must be applied to a cotton swab and applied to the inflamed area. The tampon should be changed every 3-4 hours. Have a good one therapeutic effect can be achieved after 2-3 weeks of daily use.

Lotions with aloe juice and plantain

Juice squeezed from aloe leaves has a pronounced bactericidal and anti-inflammatory effect. Such lotions draw pus from the wound, ensure its disinfection and reduce the intensity pain syndrome. Plantain has a stimulating and regenerating effect, so herbalists advise adding this component to traditional aloe treatment.

To extract juice from aloe leaves, they must be thoroughly washed. cold water, crush in your hands and cut along the side line, then squeeze out the pulp from them. Plantain can be used as an infusion: pour 10 g of dried plantain root with a glass of boiling water and leave for 2 hours. All ingredients must be mixed and refrigerated for 1 hour.

A mixture of aloe juice and plantain infusion is used in the form of lotions: a cotton swab must be moistened generously with the product and applied to the end of the fistula tract. Lotions must be changed every 4 hours. Duration of use – 2 weeks.

Lotions with calendula

This is the easiest way to treat fistulas at home. All you need is an alcohol tincture of calendula (you can buy it at a pharmacy for 30-50 rubles) and cotton pads or swabs. The tampon must be moistened generously with the tincture and applied to the fistula for 20-30 minutes. You need to make 5-6 lotions per day. The duration of treatment depends on the tolerability of the components and the existing dynamics. The recommended course of therapy is 7-10 days.

Note! Make lotions with alcohol tinctures necessary after hygienic washing. At the beginning of treatment, the patient may feel a strong burning sensation caused by the effect of ethanol on the inflamed tissue. If such sensations do not go away within 30 minutes after removing the tampon, the skin should be rinsed generously with cool running water and lubricated with a soothing ointment, for example, Bepanthen.

Olive oil and vodka ointment

This ointment helps to quickly relieve inflammation and has a positive effect on the condition of damaged tissues, stimulating their regeneration. In order for the ointment to have a thick consistency, it is necessary to purchase in advance any fat base (glycerin, badger or goose fat etc.). Mix 5 tablespoons of oil (it is better to use premium oil) with 50 ml of vodka and add 3 teaspoons of glycerin. If animal fat is used for cooking, the required thickness can be achieved using two tablespoons of fat.

All components should be thoroughly mixed and refrigerated for several hours. The ointment should be used up to 4-5 times a day; there is no need to wash it off after use. Significant improvements are usually observed already on the seventh day of treatment, but to achieve a stable result it is recommended to use the product for at least two weeks.

Rectal fistula is an unpleasant painful pathology which can lead to serious complications if not treated promptly. The only one effective method The only treatment for rectal fistulas today is excision, which can be performed without surgery or the use of a scalpel. Home methods can be used as complementary therapy, but they cannot replace full-fledged treatment.

Video - Excision of rectal fistula

Suture material used in surgery can be natural or synthetic. Ligature sutures may dissolve spontaneously some time after surgery, or they will require the help of a doctor to remove them.

If a dark cherry-colored serous fluid or purulent discharge is released at the site of the suture, this is a sign of a developed inflammatory process and formation ligature fistula. The appearance of these symptoms is a sign of ligature rejection and a reason to resume treatment. A fistula that appears after surgery cannot be considered as a normal phenomenon; urgent treatment under the guidance of a surgeon is required.

Causes of ligature fistula:

Infection in the wound due to ignoring antiseptic requirements;

Allergic reaction to suture material.

There are factors that increase the likelihood of a postoperative fistula:

Immune reactivity (usually higher in young people);

Accession chronic infection;

Hospital infection, typical for surgical and therapeutic hospitals;

Getting into the wound staphylococcus and streptococcus, which is normally always found on human skin;

Localization and type of surgical intervention (operation caesarean section, surgery for paraproctitis, etc.);

Protein depletion in cancer;

Deficiency of vitamins and minerals;

Metabolic disorders (diabetes mellitus, obesity, metabolic disorders).

Features of ligature fistulas:

Occur in any part of the body;

Occur in all types of tissue of the human body (epidermis, muscle, fascia);

Occur any time (week, month, year) after surgery;

Have different deployment clinical picture(sutures can be rejected by the body with further healing of the wound, or they can become intensely inflamed with suppuration of the wound and not heal);

They occur regardless of the material of the ligature threads.

Symptoms of ligature fistula

The development of a postoperative fistula occurs according to the following scenario:

Within a few days after the operation, the wound area thickens, swells slightly, and becomes painful. The skin around it turns red and becomes hotter to the touch than other areas.

After 6-7 days, when pressure is applied, serous fluid and pus emerge from under the suture.

The fistula can close spontaneously and later open again.

Recovery is possible only after repeated surgery.

Complications arising from the appearance of a postoperative fistula

An abscess is a cavity filled with pus;

Cellulitis – inclusion of subcutaneous fat in the inflammatory process;

Eventration – loss of internal organs due to purulent melting of tissues;

Sepsis - the spread of purulent contents in the cavity of the chest, skull, and abdominal cavity;

Toxic-resorptive fever is pronounced hyperthermia as a reaction of the body.

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Diagnostics

The primary diagnosis of a ligature fistula is carried out in the dressing room during a visual examination of the wound by a surgeon. To clarify the location of the fistula, the presence or absence of complications (abscess, purulent leaks), an ultrasound scan of the surgical wound is performed.

If the fistula is located deep in the tissue and its diagnosis is difficult, fistulography is used. During the examination, a contrast agent is injected into the fistula tract and radiography is performed. As a result of such manipulation x-ray the fistula tract will be clearly visible.

Treatment of ligature fistula

The vast majority of cases of ligature fistula can only be resolved through surgery. The longer a postoperative fistula exists, the more difficult it is to cure. Used for treatment complex therapy using medications.

Groups of drugs used to treat fistula:

Local antiseptics - water-soluble ointments (Levosin, Levomekol, Trimistan), fine powders (Gentaxan, Tyrozur, Baneocin);

Antibacterial agents – Ampicillin, Norfloxacin, Ceftriaxone, Levofloxacin;

Enzymes for the destruction of dead tissue - Trypsin, Chymotrypsin.

Since the drugs retain their effect for several hours, they are injected into the fistula tract and distributed throughout the tissues surrounding the wound several times a day.

Fat-based ointments (Synthomycin ointment, Vishnevsky ointment) prevent the outflow of pus, so they are not used in the presence of extensive purulent discharge.

In addition to surgical and drug treatment, physiotherapy is used:

quartzization of the wound surface;

As a result of the use of UHF therapy, microcirculation of blood and lymph improves, which leads to a decrease in swelling and stops the spread of infection. Quartz treatment has a detrimental effect on pathogenic bacteria, promoting stable remission of the process, although not guaranteeing complete recovery.

The “gold standard” for treating a ligature fistula is an operation that eliminates the problem completely.

Progress of the operation to eliminate the ligature fistula:

Triple processing surgical field antiseptic in the form of an alcohol solution of iodine.

Injection of an anesthetic solution into the tissue around the surgical wound and under it (Lidocaine - 2% solution, Novocaine - 5% solution).

Injection of dye into the fistula tract in order to completely examine it (“green paint” and hydrogen peroxide).

Dissection of the fistula, removal of the ligature completely.

Removal of the cause of the fistula along with revision of the surrounding tissues.

Stopping possible bleeding with an electrocoagulator or hydrogen peroxide 3%, since stitching blood vessel may provoke the appearance of a new fistula.

Wash the wound with antiseptics (Dekasan, 70% alcohol, Chlorhexidine).

Closing the wound with sutures again with the installation of active drainage.

After the operation, the patient needs dressings and drainage rinsing. If the purulent discharge is not fixed, the drainage is removed.

Medicines used in the presence of complications (phlegmonous inflammation of the tissue, purulent leaks):

Non-steroidal anti-inflammatory drugs (NSAIDs) – nimesil, diclofenac, dikloberl;

Ointments for tissue regeneration - troxevasin and methyluracil ointment;

Drugs plant origin with vitamin E (aloe, sea buckthorn oil).

Local revision of inflamed tissues with wide dissection of the fistula - classic form surgical treatment postoperative fistula. Most minimally invasive techniques are ineffective in treating this complication.

Self-medication of a ligature scar will not bring recovery, because only surgery and subsequent debridement of the wound can save the patient from complications. When attempting self-treatment, precious time will be lost.

Prognosis and prevention

In cases where the body rejects surgical sutures made of any material, the prognosis for the operation is unfavorable. The situation is the same with self-medication - in this case it is very difficult to make a forecast.

It is impossible to take preventive measures for the appearance of a fistula, since even with strict adherence to antiseptics, infection can penetrate into the surgical wound and rejection of the suture material.

A fistula is a channel that connects a body cavity or hollow organs to the external environment or to each other. A fistula is also called a fistula. Most often it is represented by a narrow tubule, which is covered from the inside with epithelium or young connective tissue. Fistulas can form against the background of various pathological processes occurring in the body, as well.

A fistula on the gum of a tooth is pathological formation, represented by a small passage through the gum to the lesion. Most often, the fistula comes from the root of the diseased tooth. It drains serous or purulent exudate. You can see the fistula at the projection site of the tooth, in its upper part. It looks like a sore spot.

Perirectal fistula occurs as a consequence of a violation metabolic processes in the tissue around the rectal ampulla. Most often, these are the consequences of paraproctitis, or proctitis, the symptom of which is a fiber abscess. Its main manifestations are purulent or bloody issues, pain, itching, irritation of the epidermis of the anal area.

Ligature fistula after surgical childbirth is one of the common complications of this operation. It is dangerous because it is a source of infection and can cause toxic damage to a woman’s body. Every operation, and delivery by cesarean section is no exception, ends with a suture.

The information on the site is intended for informational purposes only and does not encourage self-treatment; consultation with a doctor is required!

Source: http://www.ayzdorov.ru/lechenie_svish_legatyrnii.php

Ligature fistula after surgery: treatment, surgery, urinary tract, photo

Almost every surgical intervention ends with closing the wound by placing surgical sutures on it, the only exceptions being operations performed on purulent wounds, in which, on the contrary, it is necessary to create conditions for the unhindered outflow of the purulent contents of the wound and reduce inflammation around the wound.

Surgical sutures are of both natural and synthetic origin. At the same time, they are divided into those that are absorbed in the body after some time and those that are not absorbed.

There are cases when a pronounced serous inflammatory process appears at the site of sutures, which subsequently begins to secrete pus. This behavior is reliable sign that after the operation a fistula formed and the process of its rejection began. It is worth noting that the appearance of a fistula is an abnormal reaction of the body, so additional treatment is required.

Causes of ligature fistula after surgery

Rejection by the body due to an allergy to the material from which the surgical thread is made.

Infection attached to the postoperative wound (failure to keep the wound clean, insufficient antisepsis during the operation).

In addition, the following factors may influence the appearance of a ligature fistula after surgery:

Metabolic disorders in the body ( metabolic syndrome, obesity, diabetes).

Lack of minerals and vitamins.

Availability oncological diseases, which deplete the body (protein depletion).

Localization and type of surgical intervention (ligature fistula after cesarean section or fistula after surgery for paraproctitis).

A hospital infection that occurs in all hospitals and is represented by saprophytic microorganisms (streptococcus, staphylococcus), which are normally present on the skin of a healthy person.

The presence of a specific chronic infection in the body (syphilis, tuberculosis).

High immune reactivity of the body (young people full of energy).

General condition and age of the patient.

It is worth noting that ligature fistulas:

Appear in any part of the body and in any layers of the surgical wound ( internal organ, muscle, fascia, skin).

Do not depend on time (can occur in a year, month, week).

They occur regardless of the material from which the surgical thread is made.

Have different clinical manifestations(rejection of sutures with suppuration of the wound and without its healing or rejection with subsequent healing).

In the first days, compaction, slight swelling, pain, redness, and an increase in local temperature appear in the projection of the wound.

After a week, a characteristic serous fluid begins to emerge from under the surgical sutures, and especially when pressing on them, which is subsequently replaced by pus.

At the same time, there is an increase in general temperature, which increases to subfebrile levels.

Sometimes the ligature fistula closes on its own, but after a while it opens again.

Complete cure is possible only after surgery, which is aimed at eliminating the causes of inflammation.

Complications arising from ligature fistula

An abscess is a cavity filled with pus.

Cellulitis - spread purulent formations under the skin along fatty tissue.

Eventration - due to purulent melting through the surgical wound, prolapse of internal organs may occur.

Sepsis is a breakthrough of purulent contents into the cavity of the skull, chest, and abdomen.

Toxic-resorbative fever is a severe form of the body’s temperature reaction to the presence of a purulent focus in it.

Diagnostics

You can identify a ligature fistula by visiting the dressing room during a clinical examination postoperative wound. Also, if you suspect the development of a ligature fistula, you should undergo ultrasonography wounds for the presence of an abscess or purulent leaks.

If diagnosis is difficult due to the deep location of the ligature fistula, fistulography can be used. The essence of this method is to inject a contrast agent into the fistula tract, after which an X-ray examination is performed. The image will clearly show the location of the fistula tract.

Treatment

Before proceeding with the treatment of a ligature fistula, it should be noted that without surgical elimination of the source of inflammation and its consequences, a cure cannot occur, and the prolonged existence of a fistula will only aggravate the course of the disease. In the presence of a ligature fistula, complex treatment of the pathology is necessary with the mandatory use of:

the enzymes chymotrypsin and trypsin, which dissolve necrotic tissue;

antibiotics having wide range actions – ampicillin, levofloxacin, norfloxacin, ceftriaxone;

local antiseptics. Fine powders - gentaxan, baneocin, tyrosur. Water-soluble ointments - levosin, trimistin, levomekol.

Such enzymes and antiseptics are introduced directly into the fistula tract itself, as well as into the tissues surrounding it, given that the activity of such drugs and substances lasts no more than 4 hours, they are administered several times a day.

At copious discharge from a fistula of purulent masses, it is strictly forbidden to use fatty ointments (synthomycin, Vishnevsky), since they clog the fistula canal and disrupt the process of outflow of pus.

In the inflammation phase, active use of physiotherapeutic procedures (UHF therapy, wound quartz treatment) is allowed. Such procedures help improve microcirculation of lymph and blood, reducing the spread of infection and swelling, and also have a detrimental effect on pathological microorganisms in the wound. The use of such measures makes it possible to achieve stable remission, but does not guarantee complete recovery.

If a fistula does not close, getting rid of it can only be guaranteed through surgery. This treatment option for a ligature fistula is a generally accepted standard, because eliminating the cause of constant suppuration can only be achieved with surgical treatment postoperative wound with a complication that arose in it.

Sequence of actions during surgery to eliminate a ligature fistula

triple treatment of the surgical area with antiseptics (usually an alcohol solution of iodine);

introduction of anesthetic substances into the projection of the surgical wound and under the wound (0.5-5% novocaine solution, 2% lidocaine solution);

injection of dye (hydrogen peroxide and brilliant green) into the fistula tract to speed up the search;

cutting the wound and complete removal suture material;

detection of the cause of fistula formation and its removal together with surrounding tissues;

stopping bleeding using a 3% solution of hydrogen peroxide or an electrocoagulator; suturing the vessel is unacceptable, as this may cause a new fistula;

washing the wound with an antiseptic after stopping the bleeding. The most commonly used antiseptics are decasan, 70% alcohol, and chlorhexidine. After this, the wound is closed with a secondary suture, while organizing active drainage of the area.

The postoperative period involves periodic washing of the drainage and dressing. In the absence of purulent discharge drainage system is extracted. For multiple purulent leaks and phlegmon, the patient is prescribed:

ointments that stimulate the healing process (troxevasin, methyluracil);

anti-inflammatory drugs (NSAIDs - nimesil, diclofenac, dicloberl);

You can also simultaneously use phytotherapeutic preparations that are rich in vitamin E (aloe, sea buckthorn oil).

It is worth noting that the most effective for ligature fistula is the classical operation, which involves a wide dissection to perform an adequate revision. Any minimally invasive methods (using ultrasound) for such pathology are of low effectiveness.

It is important to remember that self-medication when a ligature fistula forms on a postoperative scar is unacceptable, since in the end you will still need surgical intervention to treat the fistula, but this will waste time, which may be enough for the development of complications that are dangerous to human life.

Prevention after surgery and prognosis

Preventing the appearance of a ligature fistula is, in principle, impossible, because infection can penetrate the suture even under the most aseptic conditions, and it is generally impossible to prevent a rejection reaction.

In most cases, treatment of a ligature fistula with surgery is quite effective, but there are cases when the patient’s body constantly rejects any type of surgical sutures, even after a large number of repeated operations.

Any independent treatment of a ligature fistula has an unfavorable prognosis.

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Source: http://doctoroff.ru/ligaturnyy-svishch

Fistula after surgery: how to treat?

It often happens that an infection that progresses inside seeks a way out. This especially happens after surgery. Let's look at why this happens and how the resulting fistula is treated after surgery.

Fistula - what is it?

A fistula is a canal that connects body cavities or hollow organs to each other or to the external environment. It is lined with epithelium, and through it pus comes out, or the canal is lined granulation tissue. If this does not happen, then a purulent fistula forms.

Such a process may be the result of some inflammatory process in the body or a consequence of surgery.

Types of fistulas

Depending on where the fistula is located, they are divided into:

The fistula can be complete or incomplete. A complete one has two holes and is treated faster, since it has a way out; an incomplete one, having one hole, further develops the inflammatory process, the number of bacteria increases.

The fistula can be labiform or tubular. Labial can only be treated with surgery.

If we consider the process of formation, then a granulating fistula is one that is not yet fully formed, while a tubular one is already lined with epithelium and is fully formed.

What are the reasons for the appearance of a fistula after surgery?

There are several reasons for this phenomenon:

1. The source of infection has not been completely eliminated.
2. In case of chronic prolonged inflammatory process.
3. Like the consequences of a blind gunshot wound. Small particles in the body, fragments, are perceived by the body as a foreign body, and the process of putrefaction begins.
4. The body’s denial of the threads used in surgical operations, as a result, the sutures fester.

The last point is the most common reason why a fistula appears after surgery. There are also several explanations for this:

• Non-sterile suture material.
• The body's reaction to a foreign body.

The fistula on the suture after surgery forms a seal from the suture thread itself, fibrous tissue and collagen fibers.

How to recognize the appearance of a fistula after surgery?

Since this is primarily an inflammatory process, it is necessary to recognize a fistula after surgery by characteristic symptoms not difficult. They are:

1. Around the suture in the infected area there is compaction, redness, bumps, and here the body temperature is much higher.
2. As a rule, on initial stage not the entire area of ​​the postoperative suture is inflamed.
3. Purulent discharge is observed. The less often, the greater their number.
4. The affected area becomes red, swollen and painful to the touch.
5. The suture site turns red.
6. The patient's general condition may worsen, body temperature rises to 38 degrees or higher.

If you have these symptoms, you need to see a doctor immediately, otherwise infectious process may spread to organs or cause blood poisoning.

Diagnosis of fistula

Diagnosing a fistula after surgery is not difficult, since it can be seen visually if it is external. The doctor, after listening to the patient and examining him, pays attention first of all to:

• Quantity and quality of discharge.
• The size of the fistula, its color.
• If the fistula is interorgan, then pay attention to the work neighboring organs, especially if there are changes.

In order to find out the length and direction of the fistula canal, probing and radiography are used.

It is also necessary to do a series of tests that will confirm the type of fistula. The gastric will show the presence of hydrochloric acid, and uric - the presence of uric acid salts.

It happens that the suture may begin to fester a long time after the operation, so you need to find out the reason for this phenomenon.

If a fistula does appear after surgery, how to treat it?

Treatment of fistulas

For successful therapy First of all it is necessary:

1. Eliminate the source of the inflammatory process. If it is a thread, then it is removed.
2. The doctor must conduct an examination and do a fistulography. This will show whether the fistula has a connection with the internal organs.
3. Then a mandatory course of antibiotics or anti-inflammatory drugs is prescribed, depending on the depth of the inflammatory process.
4. To maintain the body, the doctor may prescribe vitamin complex so that you have more strength to fight germs.
5. The wound is washed with a syringe with hydrogen peroxide or furatsilin solution, as these agents perfectly disinfect and promote fast healing. The procedure is carried out daily, and if there is a lot of pus, then several times a day.

As a rule, the wound begins to heal. If this does not happen, then surgical intervention is possible, in which excess granulation is removed, and the areas can be cauterized.

The newest method is the treatment of fistula after surgery using ultrasound. This method is considered the most gentle, but it is not fast.

In severe cases, if several fistulas have formed, complete excision of the postoperative scar is indicated. The infected suture material is removed and a new suture is placed.

Postoperative intervention

If you still failed to cure the fistula and had to resort to surgical methods, then after the operation to remove the fistula, healing will take place within several weeks. The wound will heal faster if you provide it with complete rest and proper care.

After surgery for a rectal fistula, the doctor, as a rule, prescribes a diet so that the wound heals faster. After such operations, painkillers and antibiotics are required. The wound heals within a month; any physical activity is avoided.

The prognosis for treatment is usually good and the patient makes a full recovery.

Traditional methods of treatment

Of course, people always try to cure the disease at home. There are several recipes for treating fistulas with folk remedies. Here are some of them.

1. It is necessary to take vodka and olive oil in equal proportions. Wet a bandage with this mixture and apply to the inflamed area. Apply a cabbage leaf overnight. At least ten such procedures are required.
2. A mixture of aloe juice and mumiyo is good at drawing pus out of a wound. Mumiyo is diluted with water to the consistency of strong tea. The bandage should be left on for a long time.
3. It is recommended to wash wounds with a decoction of St. John's wort. You can apply a bandage on top and then wrap it with oilcloth. If the solution is hot, the effect will be greater.
4. There is a recipe for an ointment that treats not only fistulas, but also non-healing wounds. It is necessary to take in equal quantities flower honey, pine resin, medical tar, butter, aloe leaf pulp, mix the ingredients and heat in a water bath. Dilute with vodka to the desired consistency. Apply ointment around the fistula, then cover with plastic and apply a bandage or plaster. The fistula will heal literally before our eyes.
5. It is good to apply softened resin. It perfectly draws out pus and heals wounds.
6. To strengthen the patient's immunity, it is recommended to drink aloe juice with honey. The recipe is as follows: you need to take 12 leaves from a three-year-old plant and leave it in the refrigerator for 10 days. Then finely chop, place in a glass bowl and pour in liquid honey until completely covered. Stir every day and leave for 6 days. Strain the infusion and consume 1 teaspoon 3 times a day before meals. After such a drug, strength appears to fight the disease, and wounds will heal faster.

It is worth noting that if a fistula has formed after surgery, then treatment should be carried out under the supervision of doctors, and folk remedies are an addition to the main course.

Prevention of fistulas

In order to prevent fistulas from appearing after surgery, it is necessary:

• First of all, observe the rules of asepsis during surgery.
• All instruments and suture material must be sterile.
• It is necessary to treat the wound before suturing it.
• Vessel doping should occur with little tissue involvement.
• Prescribe antibacterial drugs to prevent infections.
• Everything needs to be treated infectious diseases, preventing the development of fistulas.

Source: http://www.syl.ru/article/206866/new_svisch-posle-operatsii-kak-lechit

Ligature fistula

Most serious operations end with the application of a ligature - a special thread that stitches together damaged tissue layer by layer. Typically, during surgery, the wound is thoroughly washed before suturing begins. This is done using resorcinol, chlorhexidine, iodopirone and other solutions. If the thread becomes contaminated with bacteria, or the wound has not been sufficiently treated, then suppuration of the ligature occurs and, as a result, a ligature fistula is formed.

A compaction called a granuloma forms around the thread that tightens the edges of the wound. The suture material itself, collagen fibers, macrophages and fibroblasts enter this compaction. The ligature itself is not encapsulated - it is not limited to fibrous membrane. After such suppuration is opened, a fistula is formed. Most often, one fistula is formed, but there may be several, depending on where the ligature remains.

Typically, such a complication makes itself felt quite quickly, even while the patient is in hospital. medical institution, therefore, during a routine examination by a doctor, the symptoms of a ligature fistula are identified and treatment occurs in a timely manner. The fistula opens after a few days - a break appears on the skin, through which purulent discharge oozes. Along with this discharge, part of the ligature may also come out. In some cases, the process fades, the fistula closes, but after a short time it opens again. Purulent process can last for several months if you do not consult a doctor in time and do not remove the cause of the suppuration.

Symptoms of ligature fistula

Usually, a fistula cannot be ignored - it external signs are clearly expressed.

• Firstly, compaction and infiltration occurs around the wound channel. The bumps that appear become hot to the touch.
• Secondly, near the scar left after the operation, you can clearly see inflammation - redness will develop as the ligature is applied.
• Thirdly, the wound begins to quickly fester and purulent contents are separated from the outlet. The volumes of discharge may be insignificant, but with violent developing process There may be noticeable weeping.
• Fourthly, such processes provoke swelling of nearby tissues and an increase in body temperature to significant levels (39 degrees and above).

Treatment of ligature fistula

Treatment of ligature fistula must begin as soon as possible, since this is a serious complication that can lead to secondary infection, disability, and in severe cases, advanced cases and to sepsis, which threatens the patient fatal. Only a doctor should prescribe treatment, and if suppuration occurs at home, the patient must be urgently sent to the hospital. Treatment of ligature fistula can be implemented in two ways - surgical and conservative. The most commonly used surgical treatment consists of removing the infected ligature, after which the patient must undergo a course of antibiotic therapy. The patient is given a small incision to allow the pus to drain. This will protect the patient from the development of phlegmon - purulent melting of tissue, as a result of which it will be much more difficult to cure the disease. If the ligature can be removed, the fistula is closed. Otherwise, a second attempt is made after a few days until the ligature is removed.

The wound surface requires special care - the affected area must be washed with special solutions to rid the wound of pus and avoid further development of the pathological process. Typically, hydrogen peroxide or furacillin is used for this purpose. If excess granulations are present, it is recommended to cauterize them. After primary care provided, if necessary, the ligature is applied again.

Conservative treatment is possible only when the process is just beginning and the amount of discharge is minimal. In this case, the patient removes dead tissue around the fistula and thoroughly washes out the pus. If possible, also cut off those threads whose ends come out. Next, the patient is given antibiotics and immunity boosters.

Prevention

To avoid the occurrence of a ligature fistula, it is necessary to properly treat the wound before suturing and use only sterile suture material. Also, when the first signs of this complication appear, it is necessary to provide timely assistance. Usually the outcome is favorable.

6 comments

Hello! Please tell me if it is possible for me to be cured at home. On July 8, I had a cesarean section (suprapubic) and sterilization. And after 3 months, a pimple appeared 10 cm above the seam, it is brewing and hurts, something like something is palpable inside rod. It is swollen, red, painful and hot. According to the symptoms, this is a fistula. I am breastfeeding the child, tell me what can be done to continue feeding the child. The fistula has been brewing for 3 months, there was a lull, but now it has started to hurt again and twitches inside the abdomen .Two months ago I showed it to the doctor, the fistula was smaller then, the doctor said that there was nothing wrong, but if it bothers me, then I have to pay 1,400 rubles to the cashier and he will remove it for me. I have a policy. I didn’t pay, and now it has become more painful than two months ago. 6 months have passed since the operation. Thank you. I will wait for advice from you.

I developed a fistula after surgery. How are you now?

Run to the hospital in the surgical (purulent) department... Otherwise there will be problems later, I went through all this horror, from a pimple after the operation, the indifference of the doctors at the clinic, they examined me in the hospital, took tests, made a diagnosis and sent me home.. After all this, through For 6 days everything burst and pus began to flow, and for a month after the operation in the hospital I have been going to bandages with an incision and a hole in my stomach, and the pus is still flowing.. Good luck to you.. I urgently need to see a doctor..

You can't get through by phone! Tell me the nearest clinic in Krasnodar region! I am from Novorossiysk, it will be very difficult for me to undergo treatment in Moscow. Thank you

At the beginning I had a small switch and generally like a sore. But gradually it (grew). The switch gave a fever. It all became red. SO I need to see a doctor right away

Hello! Fistulas began to appear 6 years after the operation, two threads were removed normally, now a third fistula has formed, they tried to pull the thread out twice, but to no avail, a lot of pus comes out, the doctor (professor) said that we still need to wait a month, I don’t know what to do