Pimples after surgery. What is a fistula after surgery, what does it look like? Ligature fistula of a postoperative scar, fistula on a suture after childbirth, cesarean section, appendicitis: signs, causes, treatment, excision

Any treatment represents a kind of stress for the body. However, it is acne after surgery often cause a lot of inconvenience. They can arise for several reasons at once. Most often, the postoperative period is a recovery period, when the doctor prescribes antibiotics. This is necessary in order to prevent all kinds of inflammatory processes from leading to complications during the patient’s rehabilitation. However, it is antibiotics that become provocateurs for the occurrence of so-called medicinal and other areas of the skin.

Acne after surgery due to antibiotics

Such an adverse reaction occurs from most varieties of this drug. The body’s unusual reaction in the form of acne occurs because the sebaceous hair formations on the human body respond violently to the use of the drug.

The situation with the occurrence of such often painful formations is aggravated by the prolonged duration of the course of treatment. The more days the drug is used by the patient and the higher its dose, the more severe the skin rash. Sometimes acne appears on the skin as a symptom of intolerance to a particular antibiotic, but after surgery such drugs are required.

Those people who were already familiar with such rashes before the surgical procedure may experience an exacerbation due to taking medications belonging to the penicillin category. Acne after surgery is often caused by doxycycline, ampicillin, cacampiox and other drugs from this group.

Who is at risk for drug-induced acne?

Moreover, allergy sufferers can observe the occurrence literally immediately after taking the medicine. Those who develop leukemia are also at risk of acquiring such a dubious piece of jewelry. In addition, taking antibiotics disrupts the balance of intestinal bacteria and can lead to dysbiosis. This disease itself often causes profuse rashes on the human body. As a rule, such a rash remains for quite a long time, but not forever. After 2-3 weeks, acne disappears. And if a person is not inclined to form them, then they will arise again.

The redness that appears on the skin around the suture should attract more serious attention. In addition to the fact that the body is weakened due to illness, microbes could get into the wound. It is they that can cause the formation of acne in a given place. They are generously lubricated with standard brilliant green, which is often quite enough to get rid of such an ailment.

Hello, Sergey.

Those “two holes” that formed on your postoperative suture are nothing more than fistulas, which indicate the development of an inflammatory process in the human body after surgery. Fistulas can occur immediately after postoperative sutures are placed, or they can appear many years after surgery.

Infection and inflammation after surgery can occur for many reasons. If you are talking about pus being released from there, then there was definitely an infection.

By the way, the fistula canal can go not only outside, but also inside, therefore, pus comes out not only to the surface, but also into the internal cavity. This often happens if during an operation a foreign body enters the body, which then begins to be rejected by the body, the patient behaves incorrectly after the operation, or an infection gets into an open wound. The infection can have a profound effect on a person’s immunity, and over time, the body’s protective functions gradually weaken, and the inflammatory process, accompanied by suppuration, intensifies.

Fistulas can be divided into certain types and depend on their location (rectal, gastric, bronchial, etc.). A ligature fistula is one that appears after the application of non-absorbable threads. If your stitches were removed, then you have formed ligature fistulas (since there are two holes). Ligature fistulas appear due to violations of the rules of antiseptic treatment of postoperative sutures and wounds after removal of surgical threads.

The discharge of pus from the holes indicates that there is an infection in the wound. Also, when removing the threads, doctors could leave part of the thread (ligature) in the wound, which infected the wound and led to suppuration. Also, the ligature could have been infected initially, i.e. at the moment when the suture was just being applied. Lack of treatment in this case leads not only to serious inflammatory processes, but also to complete or partial divergence of the sutures.

Treatment methods for postoperative fistulas

If a patient with a fistula has a fairly strong body and a strong immune system, then the therapy proceeds quickly, and the recovery period does not drag on much. If inflammation is observed at the suture site, then treatment of ligature fistulas will most likely be carried out using surgical methods.

A diagnosis must be made to determine the presence of a foreign body in the wound. Today, modern technologies are used for this, giving quick and truthful results. If doctors’ suspicions about a foreign object are confirmed, then the fistulas will be opened, and both the foreign object and the purulent masses will be removed through a special channel.

Further treatment can be medicinal, but this, as mentioned earlier, depends on the person’s immunity, the specifics of infection and inflammation of the suture, as well as the activity of pathogenic microorganisms. Sometimes after the manipulations the fistula resolves itself, but this does not happen in all cases. In the absence of proper treatment, the disease will begin to actively progress, giving dangerous complications to the functioning of the entire body.

  • Conservative therapy methods are used if there are few fistulas and the amount of pus released does not exceed acceptable levels. Dead tissue is gradually removed and pus is removed, carrying out regular antiseptic measures to treat problem areas. In parallel, the patient takes antibacterial drugs and those whose action is aimed at strengthening the immune system.
  • Surgical therapy is prescribed to patients who have a lot of fistulas, and the flow of purulent masses is abundant and intense. If the presence of a foreign body or the development of complications is confirmed, then surgery is also necessary. The operation involves excision of the fistula canal, cauterization of the affected tissues or their removal. Sometimes the postoperative suture is removed along with the fistulas - this is a complex and extensive operation.

In any case, you need to urgently seek help from a surgeon, who will take the necessary diagnostic measures and then prescribe effective treatment.

Best regards, Natalya.

How is a fistula that appears after surgery treated? We will introduce you to the most effective methods of treating ligature fistulas, and also tell you why they appear.

Any, even the simplest, surgical intervention on the human body, as a rule, requires quite a lot of time for wounds to heal. Absolutely all operations end with sutures, which should contribute to a faster and better recovery of the patient.

But sometimes, precisely in the place where the open wound was sutured, a strong inflammatory process begins, which is characterized by redness of the skin and the formation of pus. All this indicates that the person has developed a rather serious complication that requires immediate and high-quality treatment.

If you do not start fighting the fistula as quickly as possible, then it is likely that the patient may require another surgical intervention.

What is a fistula after surgery, what does it look like?

A fistula has formed in the middle of the seam
  • Fistula is a hollow channel inside the human body that connects human organs with the external environment. Also, a fistula can connect an internal cavity with a benign or malignant formation. As a rule, this tube is lined with epithelium and is a channel through which pus formed inside the body after surgery is released.
  • Outwardly, it looks like an ordinary deep wound, around which the skin has become inflamed. A fistula can appear on almost any part of the body, and not necessarily in the place where the incision was made. There are cases when the inflammatory process occurs inside the body for a long time and a person learns that something is wrong with him only when a characteristic hole appears on his body, releasing purulent masses
  • But not only pus can be released from the fistula; if the problem has not been dealt with for a long time, and it has affected the internal organs, then feces, urine and bile can be released from the canal that has formed


Fistula in the coccyx area

In addition, doctors distinguish several other types of postoperative fistulas:

  1. Full. It has two outlets at once, which contributes to faster relief of the inflammatory process and healing
  2. Incomplete. It has only one exit, which is usually located inside the abdominal cavity. This contributes to the intensive proliferation of pathogenic microflora and increased inflammatory processes
  3. Lip-shaped. In this case, the fistula fuses with the dermatological tissue and muscle tissue. It can only be removed surgically
  4. Granulating. This type of fistula is characterized by the formation of granulation tissue, hyperemia and quite severe swelling
  5. Tubular. A fully formed duct that secretes pus, mucus and feces

Ligature fistula of postoperative scar after childbirth, cesarean section, appendicitis: signs, causes



Ligature fistula
  • Ligature- these are special medical threads that doctors use for layer-by-layer stitching of tissues damaged during surgery. Usually, before using them, the open wound is thoroughly treated with disinfectants and only after this proceed to suturing
  • But sometimes such actions are not enough and pathogenic bacteria enter the body along with the thread, provoking severe suppuration and the formation of a ligature postoperative fistula. As a rule, it opens after a few days and the material that was used to stitch the wound comes out along with pus.
  • Most often, this problem is caused by silk threads, so recently doctors have begun to use a material that dissolves on its own after a minimum period of time and does not require the removal of sutures or additional processing


The main reason for the development of postoperative fistula is infection

The main reasons for the appearance of a fistula after surgery:

  • Orgasm perceives the material that was used to stitch the wound as a foreign body and begins to reject it
  • The wound itself, as well as the ligature, becomes infected
  • Untimely and poor-quality processing of the postoperative suture
  • The patient is too old
  • Overweight
  • Reduced immunity

Signs of a fistula:

  • A seal appears around the cut in the skin, which begins to hurt noticeably when pressed. In some cases, pronounced tubercles appear that secrete infiltrate
  • Redness will be clearly visible near the infected scar. Moreover, it will look brightest as the ligature is applied
  • The temperature may rise very sharply. And since the inflammatory process in the body will intensify all the time, it will not go astray to normal levels
  • Severe suppuration appears, which, if not treated correctly, turns into a weeping quite large size
  • The fistula opening may heal for a while and then become inflamed with renewed vigor.

Consequences that cause fistulas



Postoperative fistula can provoke the development of sepsis

Postoperative fistula itself is not life-threatening. But if the patient lets everything take its course, then the pathogenic bacteria that are inside the fistula opening will begin to infect healthy organs and tissues, and this will provoke the appearance of quite serious diseases.

In addition, the body may refuse to respond correctly to medical therapy, which in turn can also cause quite serious complications.

The most common complications in the treatment of fistula after surgery:

  • Abscess. Purulent masses fill the entire internal cavity of the fistula opening
  • Phlegmon. In this case, the pus, in addition to tissues, also begins to affect fatty tissue.
  • Sepsis. A fistula opening occurs inside the human body. The pus ends up on the patient’s internal organs.
  • Fever,provoked by a purulent mass. Temperatures can rise to maximum levels. In this case, a person may lose consciousness and have difficulty oriented in space.

Purulent fistula on a surgical suture - treatment



Treatment of purulent fistula
  • As you probably already understood, a purulent fistula is not a death sentence and, with proper treatment, almost always responds quite well to treatment. But still, in most cases, surgery is usually required for a favorable outcome.
  • If the doctor decides to delay the intervention, the patient will be prescribed conservative treatment. But it should also be carried out under the strict supervision of a specialist and preferably in a hospital setting. Typically, such treatment is aimed at eliminating pathogenic microflora that provokes inflammation
  • If the therapy is chosen correctly, the fistula opening will heal quite quickly and the patient will be able to return to normal life. To treat an inflamed area of ​​skin, drugs that have antiseptic, antibacterial and bactericidal effects are usually used
  • In addition, the patient must be prescribed antibiotics and vitamins, which help maintain the body’s defenses at a normal level. But I would like to immediately say that conservative treatment does not provide a 100% guarantee that the fistula will not reopen. Therefore, most doctors suggest not to suffer and immediately perform surgery to remove the purulent focus


Only surgical intervention can help completely get rid of the fistula.
  • After washing the wound, drainage is usually installed in it. In the postoperative period, the drainage is washed daily and sterile dressings are changed. If after a few days the amount of purulent masses does not begin to decrease, then the patient is additionally prescribed anti-inflammatory drugs, antibiotics and vitamin E
  • In addition, bandages and ointments can be used to stimulate the healing process. In this case, for example, troxevasin ointment may be prescribed. As soon as the purulent ceases to be released, the drainage is removed from the wound and then the patient can only make sure that no infection gets into it and periodically change the bandage



Folk remedies for the treatment of fistula

In a trailer, it is permissible to treat ligature postoperative fistulas using traditional methods. Some of the methods described below remove inflammation quite well and reduce the amount of pus.

But still, if you decide to get rid of the problem in this way, then before starting treatment, be sure to consult with a specialist. After all, if you have neglected your condition very much, then it is likely that you will only aggravate the course of the disease.

So:

  • Take equal parts olive oil and strong vodka and mix until smooth. Wipe the inflamed area of ​​skin with the resulting mixture 3-4 times a day. To enhance the therapeutic effect, you can immediately apply a cabbage leaf previously scalded with boiling water. This way you will not only kill pathogenic microflora, but also contribute to a faster discharge of pus
  • To prepare the next miracle remedy, you will need mumiyo and aloe juice. The mummy should be soaked in boiled water, and when it turns it dark brown, add aloe juice to it. You will need to moisten a sterile bandage in this solution and apply it to the sore spot.


St. John's wort decoction for the treatment of fistulas
  • If you need to draw out pus as quickly as possible, then use the familiar herb St. John's wort for this. In this case, you can use both the decoction and the leaves. First, tear off the St. John's wort leaves, fill them with water, and then simmer over low heat for 10-15 minutes. When the broth has cooled a little, soak a bandage in it and place the leaves on it in one layer. Fix this bandage on the fistula and leave it there for 4 hours. After this time, the bandage must be removed, the sore spot treated with hydrogen peroxide, and then a fresh one applied.
  • A decoction of celandine will help you fight fistula from the inside. If you prepare a decoction from this plant and take it regularly for a month, the substances that it contains will kill the infection located in the fistula opening and help relieve inflammation. But since this decoction thickens the blood very strongly, it will be better if the dosage is determined by a doctor
  • You can try to get rid of a fistula with regular black bread. Take the pulp and lightly sprinkle it with water. When the top layer softens a little, apply the bread to the sore spot and secure with a sterile bandage. This procedure must be carried out once a day. Before each znamenny bread, be sure to treat the wound with hydrogen peroxide. If you do everything correctly, then approximately on the third day you will see that the fistula is completely cleared of pus and begins to heal

Ointment for the treatment of postoperative fistula



Ointment with calendula for healing fistulas

Home-made ointments have also proven themselves quite well. They eliminate the cause of the infection quite well and contribute to a faster restoration of the dermatological integument. But even in this case, it is extremely important to be very careful when applying the ointment, as well as pre-treatment of the wound.

You need to protect yourself from re-infection of the fistula opening. After all, if you apply unsterile dressings and use a product of questionable quality, you are unlikely to improve your condition.

The most popular ointments:

  • At home, you can also use an ointment that will have anti-inflammatory and healing properties. To prepare it, you will need pine resin, natural honey, butter, aloe pulp and medical tar. All ingredients are mixed in equal parts and brought to homogeneity in a water bath. The resulting product should be applied to previously disinfected areas of the skin.
  • Another effective remedy is ointment made from fresh calendula flowers. They need to be tightly folded into a half-liter jar and filled with melted pork fat or butter. Leave the product in a dark place to brew for 10-12 hours. Then transfer it to a clay pot and simmer for 48 hours in the oven at 70 degrees. After the ointment has cooled, transfer it to a container with an airtight lid and store in a cool, dark place. You can simply lubricate the fistula opening with the resulting product or make medicinal dressings from it.



As already mentioned a little above, the best way to get rid of a postoperative fistula is to carry out its complete excision. Although this procedure is quite painful and has a fairly long recovery period, it will protect you from the development of complications such as sepsis and phlegmon.

Stages of the operation:

  1. First, the fistula opening and all the skin around it are treated with antiseptic agents.
  2. Anesthetic substances are then injected into the wound area
  3. At the next stage, the wound is carefully dissected and all pus and remnants of the ligature are removed from it.
  4. After this, everything is washed well, drainage is installed and closed with a secondary suture.
  5. In this case, the vessels are not sutured, as this can lead to the formation of another fistula

After surgery, the affected area of ​​skin will require special care. The wound will definitely need to be treated with disinfecting solutions (for example, furatsilin) ​​and ensure that it is clean and dry at all times. If, even after surgery, excessive granulation is noticeable at the site of fistula formation, it must be cauterized immediately.

Video: Ligature fistula of the perineum

Hello! Two weeks ago I had surgery to remove my gallbladder using laparoscopy. Everything was fine, I treated the seams with brilliant green, but then a rash appeared and irritation around the seams, especially around the navel, began to itch. Why could this be: irritation with brilliant green? The dermatologist said it was just irritation and prescribed zinc ointment and some antibiotic ointment. I’ve been applying it for the 3rd day now, but there is no relief yet. What should I do? And what is it?

Tsurikova Svetlana, Yelnya

ANSWERED: 11/11/2013

Dear Svetlana! What you are describing is allergic dermatitis, which developed, in this case, due to “green stuff”. In this case, any hormonal ointment will help you well: “Ftorcort”, “Oxycort”, “Lorinden”, etc. And in the future, if necessary, replace the brilliant green with solutions of Chlorhexidine, Miramistin or other semi-alcoholic solutions. Be healthy!

Clarification question

QUESTION FOR CLARIFICATION 21.10.2014 Zapaschikova Olga, With. Perelub Saratov region

Hello. 2 weeks ago I had surgery to remove my gallbladder. All stitches are healing normally. But one is very bad, red and itchy. At the clinic, the doctor told me to apply zinc ointment and treat it with vodka. Tell me something please.

ANSWERED: 10/21/2014 Prutyan Grigory Valerievich Saint Petersburg 0.0 Dermatovenerologist

You may have allergic contact dermatitis: http://www.dermatolog-gtn.ru/dermatit.html But paratraumatic eczema cannot be ruled out. Post a photo of the rash here or on the VK group page: http://vk.com/public59843996

Clarification question

Related questions:

Date Question Status
17.08.2015

Hello! Three weeks ago I had surgery to remove my gallbladder using laparoscopy. Everything was fine, I treated the seams with alcohol, then brilliant green and sealed them with a cosmopor plaster. I took off the patch and in the places where it was stuck, a rash appeared and irritation appeared around the seams, especially around the navel, it began to itch very much around all the seams, even those where I had not glued them. In addition, the seam near the navel began to get wet. I sprinkle it with baneocin and apply acriderm to the irritation. Am I doing the right thing? ...

18.06.2019

After the operation everything was fine, the stitches were removed and after two days they were told to remove the bandages. After this, irritation began in the form of a rash from the navel with an expansion of the territory to the chest to the second seam. Two and a half weeks have passed now, and there is no improvement. I smeared it generously with brilliant green and zinc ointment, and drank Suprastin for three days. You probably need professional help. You can’t get through to our surgeon - there’s a waiting list for a month in advance. Help please.

19.07.2015

Good afternoon We need your help! A couple of months ago, a rash appeared on the upper eyelids (closer to the bridge of the nose) and in the navel, the itching is insignificant, and sometimes it peels off. I went to a dermatologist, the only thing they checked was for fungi, there were none and they immediately prescribed L-cet tablets and Pimafucort ointment. When I asked what I had, “yes, it’s just ordinary dermatitis, an allergy to something, don’t worry.” I took the tablets, but we didn’t have such an ointment in our pharmacy, so I bought Hyoxysone. After a 10-day course, no...

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Two weeks ago I had palas surgery to remove the gallbladder, a week ago a rash appeared around the suture and itched, what should I do?

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Hello! During the year, 3 operations were performed: an obstruction in the intestines, removal of the gallbladder, and a hernia operation using a mesh. After the last operation, there is a hematoma in the abdominal cavity. The surgeon recommended applying Trombless and Indovazin ointments around the suture. I've been using it for 5 months now. Isn't this harmful? Will this dissolve the mesh or something else that is not what is needed? With respect to you.

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Any surgical intervention, for whatever reason, causes a wound to the patient, which subsequently requires care until healing.

Unfortunately, quite often, in the process of restoring damaged tissues, various complications arise, the most common of which is suppuration. This happens no matter how carefully and correctly the operation was performed; even after all actions have been performed perfectly, the postoperative wound may begin to fester.

Causes of suppuration of a postoperative wound

Most often, the appearance of suppuration of postoperative wounds occurs due to:

Seam processing and dressing

Sutures are treated after each operation using antiseptic solutions and special preparations.

Before starting the dressing procedure, you should wash your hands thoroughly with soap and water.(it is recommended to do this up to the elbows), dry them with a paper towel and put on gloves. After this, you need to remove the dirty bandage that was applied. If the gauze has dried in some places to the incision site, you should not tear it off, you just need to moisten the bandage with hydrogen peroxide in these places and wait a little.

After removing the bandage, the gloves must be changed or thoroughly washed and treated with a disinfectant solution. The seams and tissue incision line should be spilled with a solution, blotted with a sterile cloth and allowed to dry. If there is no suppuration and blood does not ooze anywhere, then you can treat the wound and the surface of the skin around it, as well as the sutures, with regular treatment, applying it in a thin layer once a day when changing the dressing.

If the postoperative injury has not yet healed, after treatment it is necessary to apply brilliant green only to the area of ​​the skin around the incision line, and an ointment should be applied to the wound itself to prevent suppuration or eliminate it if inflammation has already begun.

An important point is that when treating wounds after operations and changing dressings, under no circumstances should you peel off the scabs that have formed and the existing whitish coating.

Scabs and plaque formation indicate that the process of formation of new tissues and epithelium has already begun at the site of damage. An attempt to remove scabs and such plaque will lead to the formation of serious scars in the future.

Removal of applied sutures is carried out, as a rule, from the 7th to the 14th day after the operation., which depends on the scale of the section and its complexity. The procedure is performed without any anesthesia, as it only causes pain to patients in rare cases. Before removing sutures and after this procedure, the skin and incision site are treated with antiseptics.

Treatment of inflammation

If signs of suppuration of a postoperative wound appear, it is necessary to begin its treatment as soon as possible. Treatment of such a wound is carried out according to the same scheme as any other purulent wound and consists of frequent changes of dressings with proper treatment with antiseptics, disinfectants and anti-inflammatory drugs.

The action of modern ointments is long-lasting, and the effects are pronounced, which allows postoperative wounds to heal much faster and eliminate inflammatory processes, with virtually no side effects. Such indicators of many drugs allow them to be used for the treatment of wounds and for a long time, if necessary.

Application has many advantages. In particular, the ointment has a fairly thick but soft structure, which allows it to be applied to any part of the body without fear of it dripping (unlike liquid preparations). The special formula of such products allows them to quickly penetrate deep into damaged tissues, while creating a protective film on the surface of the wound.

The use of ointments is safer than injections or oral antibiotics, since ointments have only a local effect without creating a systemic effect.

An ointment for eliminating suppuration of postoperative wounds and treating other purulent wounds should solve certain problems:

  • Fight infection inside the wound.
  • Help remove dead tissue and cleanse purulent formations.
  • Eliminate the inflammatory process, stopping its development.
  • Do not create obstacles for the release of pus.
  • Protect the wound from penetration of harmful microorganisms.

Related articles

The first stage of wound healing after surgery usually begins on the third day. During this period, you can use ointments that have a water base, promoting faster healing of the injury, eliminating inflammation, preventing the penetration of infection or suppressing its development. These drugs include ointments: Sulfamekol, Ichthyol, Dioxin, Zinc.

For faster restoration of injured tissue, ointments that activate regeneration processes and also eliminate bacterial infections should be applied to the cleaned surface of postoperative injuries.

For the treatment of postoperative sutures, they are used because they contribute to the formation of higher quality granulation. Most often in this group of products, ointments based on Tetracycline and Gentamicin are used.

You can also use universal ointments that have a combined composition. Such agents are highly effective in eliminating the inflammatory process and accelerating wound healing. Drugs in this group include Vishnevsky ointment, Oxycyclosol, Solcoseryl, Levomethoxin.

Folk remedies

Treatment of sutures after operations using traditional medicine can significantly speed up the process of restoration of injured tissues and avoid many complications. Traditional medicine has many different recipes.

The most effective folk remedies for treating wounds after surgery:

Complications and consequences

The main complication after surgery is wound suppuration, which must be combated by all means.

Often, after the sutures are removed and the patient is discharged home, the inflammatory process begins again and repeated suppuration occurs. This happens with secondary infection of a protracted wound, for example, in cases where a person begins to peel off the crusts that have formed along the cut line, thereby injuring new tissue. With such actions, harmful microorganisms can enter small wounds and cause a new inflammatory process.

Secondary infection or the spread of an existing one often occurs due to improper and insufficient treatment of sutures, when the patient neglects to change dressings in a timely manner and does not use prescribed products.

After discharge home, special attention should be paid to the condition of the sutures and the resulting scar. If severe redness of the skin, swelling, swelling of the tissues, or new purulent formations appear around it, you should immediately consult a doctor.