Fistulas on postoperative sutures. Postoperative fistula treatment

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, the fistulas will be opened, and both the foreign object and 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.

Sincerely, Natalia.

Fistula after surgery: treatment and consequences

A fistula is a canal that connects deeply located tissues, organs, body cavities with the surface of the body.

Causes

Fistulas can be acquired or congenital. There are many reasons, but there are the most common causes of fistula formation. One of the causes of acquired fistulas is fistulas that occur after operations. Postoperative intestinal fistulas occur most often. An intestinal fistula is a connection between the intestinal cavity and the surface of the body or internal organ. There are two main categories of causes of postoperative fistulas:

1. At the beginning of the operation, there is a purulent-inflammatory process in the abdominal cavity.

2. Technical and tactical errors made during the operation. Poor management of the postoperative period.

In the first case, intestinal fistulas are formed after opening and draining (a tube is installed in the area of the abdominal abscess, through which the purulent discharge of the wound comes out) of abscesses (ulcers) of the abdominal cavity due to inoperable decaying malignant tumors, gangrenous forms of acute appendicitis. After surgical removal of the purulent focus, the inflammation spreads to the surrounding tissues (intestines), as a result of which a defect is formed in the intestinal wall and the intestinal contents leak into the wound. This is how a fistula is formed.

Errors

Errors of a technical nature include the wrong choice of anesthesia, access or small incision, which create difficulties for a high-quality revision of the abdominal cavity (cleaning the abdominal cavity of pus, sources of inflammation). Also technical errors include rough surgical technique, prolonged exposure of drains (rubber tubes) to remove pus) from hard rubber in the abdominal cavity, which leads to the development of bedsores of the intestinal wall.

Treatment

Treatment of external fistulas is a complex task. It includes both surgical and conservative treatment. The general principles of treatment consist of three factors: 1. local treatment. 2. general treatment. 3. Surgical treatment.

Local treatment:

1. Treatment of a purulent wound (ointment dressings, dressings with antiseptics, etc.)

2. Protection of the skin surface from the digestive effect of the intestinal contents of the fistula (pastes, ointments, powders that prevent contact of intestinal contents with the skin, colostomy bags for collecting intestinal discharge).

General treatment:

1. Treatment of inflammation in the abdominal cavity.

2. Rational nutrition (protein diet), parenteral nutrition (nutrient solutions through a vein).

3. Reduction of intoxication phenomena.

4. Increasing the body's defenses (vitamins, polyoxidonium).

Surgical treatment is used for long-term non-healing fistulas, for formed (lip-shaped) fistulas of the colon and small intestine, because such fistulas do not heal.

The essence of the operation is to completely remove the epithelial cover of the fistula. Sometimes they resort to resection of part of a hollow organ.

If the fistula is not treated, the patient develops severe dermatitis of areas of the skin in contact with intestinal discharge. Severe intoxication develops when the purulent process reaches large sizes. Patients progressively lose weight, since intestinal contents containing the products of food digestion, amino acids, carbohydrates, etc. are lost through the fistula.

Fistula on the gum of a child

A fistula is a pathological canal connecting tissues, cavities and organs with the outer surface of the body.

A fistula on the gums of a child usually occurs due to inflammation in the area of the apex of the root of a tooth.

Ligature fistula after cesarean section

In clinical practice, a ligature fistula is a complication of postoperative scars. It is formed as a result of inflammation and suppuration of non-absorbable ligatures with which the postoperative wound was sutured.

Rectal fistula: treatment at home

An intestinal fistula is an opening isolated from the abdominal cavity. Through such an opening, the intestine can communicate with the environment and also with another hollow organ. A rectal fistula can open into the reproductive system (the vagina, uterus), as well as into the urinary system (the bladder and urethra or urethra), and into the perineal area.

Fistula on the leg: causes and treatment

A fistula is an artificial canal formed as a result of an inflammatory-purulent process. In other words, a fistula is a tubular path through which pus accumulated in soft or bone tissue comes out, emptying an abscess or phlegmon. In the lower extremities, when such a pathology appears, you should sound the alarm and quickly contact a surgeon or traumatologist.

Liver drainage: necessity, technique and consequences

Liver drainage is a procedure for removing pus that has accumulated in the liver parenchyma due to an abscess (an abscess is a cavity in an organ filled with pus). Liver drainage is also carried out when pus accumulates in the gallbladder and perihepatic tissue.

A fistula, or as this internal canal in the human body is also called, fistula, is represented by a canal that connects the human genital organs with the external environment.

A fistula can also be a channel that connects a cavity or surface of the body to a tumor developing inside.

Externally, the fistula looks like the simplest canal, which is covered with a layer of epithelium - the upper layer of the skin.

By type, fistulas can be distinguished as a consequence of certain pathological processes in the body, or as a consequence of surgical intervention. This is the second type we will talk about. Just such a fistula can occur when the contents of the genital organ are diverted.

What is a postoperative fistula?

Let’s say right away that a fistula that forms in the patient’s body after surgery can be classified as a classic complication after surgery. Note that the reasons that lead to the formation of a fistula are:

Suppuration in the area of operation.
Eventration.
Infiltration in the area of surgical sutures.

In any case, the underlying possibility is that the suture tissue remains contaminated after the operation. By suture we mean ligatures, or ligature threads. Pathogenic microorganisms remain on them, which lead to the formation of compaction, granulomas.

Granuloma, in turn, consists of a ligature thread and cells with fibrous tissue. Macrophages and collagen fibers may also be present here, which then, after all sutures have completely healed, can lead to the formation of scars.

At the same time, we especially note that the fistula does not have to be pronounced and cause discomfort or pain. Small fistulas are also diagnosed, which do not manifest themselves at all and the patient does not even feel them.

And yet, most often it can be stated that fistulas are formed after the use of a special silk thread.

Symptoms of postoperative fistula

If the fistula is large in size, then its development always takes place against the background of pronounced manifestations and symptoms. Let's define the main ones:

An inflammatory process begins around the sutured wound. Small tubercles are formed, mushroom-shaped granulations that are hot to the touch.
The inflammatory process does not affect the entire postoperative suture, but only a part.
From the wound, the area affected by inflammation, pus begins to be released. Sometimes it can be represented by a small amount, but in the overwhelming majority of cases, a lot of pus is released.
The place where the stitches are placed begins to change color and turns red.
In the area of fistula formation, swelling and the first signs of pain begin to appear, which may intensify.
An increase in body temperature up to 39 degrees can be diagnosed.

Fistula and its consequences

If the fistula does not go away for a long time, then its main consequence may be suppuration of the ligature thread, which develops into an abscess.

It is worth noting here that ligature fistulas can repeatedly cause infection of the postoperative suture. In addition, there is a possibility of intoxication of the entire body, which can lead to disability.

Important! Frequent discharge of pus from the opening of the fistula can lead to the onset of dermatitis, which can develop into a chronic condition.

Interestingly, the occurrence of a fistula does not necessarily occur in a short time after surgery; its development can often be diagnosed several months after a successful surgical intervention.

Treatment of postoperative fistula

In principle, the ligature thread can independently come out along with the pus, after the suppuration reaches a critical point, so to speak. However, this happens in rare cases, and simply observing the development of a fistula without turning to doctors for help would be a completely wrong move.

You just need to immediately consult a doctor at the first symptoms. Moreover, treating a fistula on your own, and even at home, is extremely dangerous and contraindicated.

First of all, the treatment consists of removing the festering ligature thread again surgically. Afterwards a course of antibiotics and anti-inflammatory drugs is prescribed.

Be sure to add a dose to the course of treatment, which is designed to help restore immunity and maintain it at the desired level.

As for wound healing after removal of the festering thread, sanitation is used here, which is carried out by washing with a solution of furatsilin. You can also use hydrogen peroxide. Both of these remedies not only perfectly disinfect the surface of the wound, but also remove the pus that is released.

Along with the removal of the suppurating ligature, cauterization and scraping of granulations, which appear in excess during inflammation of the fistula, can be carried out.

In addition to these measures, there is a more gentle method of treating postoperative fistula, which involves the use of ultrasound.

When several channels are formed at once, the doctor decides to perform surgical excision of the scar, and the tissue is completely removed along with the ligature thread, and a new suture is applied to the operation site. Let us remember that we previously wrote about.

A fistula is a pathological channel that connects a hollow organ and the external environment or two hollow organs. Most often appearsfistula after surgery. Treatment of this formation is quite long and painful. That is why the patient must strictly adhere to the doctor’s instructions.

A fistula is a hollow neoplasm that in appearance resembles a deep wound. In accordance with the characteristics of the development of neoplasms, they can be:

Lip-shaped. In this case, fusion of fistulas and skin, as well as muscle tissue, is observed. Removal of fistulas is carried out using a surgical method.
Full. It is characterized by the presence of two outputs, which provides the opportunity to combat the inflammatory process as effectively as possible.
Tubular. It is a fully formed canal from which there is a constant release of feces, pus and mucus.
Incomplete. The neoplasm is characterized by one exit, the location of which is the abdominal cavity. With this type of fistula, pathogenic microflora multiplies and inflammation worsens.
Granulating. With this type of fistula, granulation tissue is formed. With this pathological process, swelling and hyperemia are quite often observed.

About, what is a fistula after surgeryonly the doctor knows. After carrying out the appropriate diagnostics, the specialist will be able to determine the type of formation, which will have a positive effect on the treatment process.

Reasons for appearance

Postoperative fistulascan develop for a variety of reasons. Most often, pathology is observed against the background of an infectious process that enters the human body through sutures and wounds. After surgery, the human body can reject the thread, which is explained by intolerance to its components. Against this background appearspostoperative fistula. The development of neoplasms can be diagnosed in the presence of other provoking factors, which include:

High immune reactivity of the body;
Elderly age;
Chronic specific infection;
Hospital infection;
Oncological diseases.

If the human body receives vitamins and minerals in insufficient quantities, this leads to the formation of fistulas. Postoperative fistula, treatmentwhich is very long-lasting, appears when there is a metabolic disorder - diabetes, metabolic syndrome, obesity.

Before, how to treat a fistula after surgery, it is necessary to determine the cause of its occurrence. Therapy for pathology should be aimed at eliminating it.

Symptoms

Fistulas after surgerycharacterized by the presence of certain characteristics. Initially, a thickening appears on the skin around the size. When it is palpated, pain is observed. In some patients, the appearance of pronounced tubercles is diagnosed, which secretes the infiltrate. At the site of infection of the scar, redness of the skin may be observed.

The pathological process is often accompanied by a sharp increase in body temperature. This is explained by the inflammatory process in the human body. It is impossible to bring the temperature down to normal. Fistulas are accompanied by a purulent process. If the pathology is not treated in a timely manner, the size of the abscess increases significantly. Patients experience tightening of the fistula opening for a certain period. After this, inflammation develops.

Fistulas are characterized by the presence of certain signs. If they appear, patients are advised to immediately consult a doctor. Timely treatment of the disease will eliminate the possibility of side effects.

Features of therapy

Treatment of fistula after surgeryin most cases requires surgical intervention. Initially, the surgical field is treated with special antiseptic solutions, which will eliminate the possibility of infection. Surgery requires the use of local therapy. In order for the surgeon to find the course of the fistula as quickly as possible, a dye solution is injected into it.

The surgeon uses a scalpel to remove the fistula. All other actions of specialists are aimed at stopping bleeding. After this, it is recommended to wash the wound with an antiseptic solution. Postoperative sutures are applied to the wound. In this case, it is recommended to use active drainage.

Treatment of postoperative fistulas requires the use of not only surgery, but also appropriate medications. In most cases, patients are prescribed antibiotics and anti-inflammatory drugs:

Diclofenac;
Nimesila;
Dicloberla.

In order to speed up the wound healing process, the use of Troxevasin or Methyluracil ointment is recommended. It is also recommended to use drugs that are of plant origin - aloe, sea buckthorn oil, etc.

That, How long does it take for a fistula to heal after surgery?, directly depends on the characteristics of the rehabilitation period. Patients are recommended to carry out daily hygiene procedures in the area of the operation. The patient is recommended to disinfect the sutures daily using special preparations. The patient's diet should be rich in fiber, which will eliminate the possibility of constipation. In the postoperative period, it is recommended to avoid heavy physical activity. Long-term work in a sedentary position must be avoided for three months.

How it appears fistula after surgery, what is it?only the doctor knows. That is why, if tumors occur, it is necessary to seek help from a doctor who will determine the type of formation and prescribe rational therapy.

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

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 it is in the place where the open wound was sutured that 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 is a hollow channel inside the human body that connects human organs to 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 is 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.

In addition, doctors distinguish several more types of postoperative fistulas: 1 Complete. 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 canal that secretes pus, mucus and feces. Ligature fistula of postoperative scar after childbirth, cesarean section, appendicitis: signs, causes.

A ligature is a special medical thread that doctors use to stitch layer-by-layer tissue damaged during surgery. Usually, before using them, the open wound is thoroughly treated with disinfectants and only then 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 up after a few days and the material that was used to stitch the wound comes out along with the pus. Most often, this problem is caused by silk threads, so Lately doctors began to use a material that dissolves on its own after a short period of time and does not require the removal of sutures or additional processing.

The main reasons for the appearance of a fistula after surgery: Orgasm perceives the material that was used to suture 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 treatment of the postoperative suture. The patient is too old. Excess weight. 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 release an infiltrate. Redness will be clearly noticeable 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 hole of quite large size. The fistula opening can heal for a while, and then become inflamed with renewed vigor .Consequences that cause fistulas.

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 treatment therapy, which in turn also can cause quite serious complications. The most common complications in the treatment of a 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. In this case, pus enters the internal organs of the patient. Fever provoked by a purulent mass. Temperature readings 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.

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, for a favorable outcome, surgery is usually required. 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 the 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 is necessarily 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.

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 with ointments can be used that will 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, be sure to consult a specialist before starting treatment. 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 the 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.

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 the 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 much, it will be better if the dosage is determined by a doctor. You can try to get rid of the 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.

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 in 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 must 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. Excision of postoperative fistula.

As mentioned a little above, the best way to get rid of a postoperative fistula is to completely excise it. 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: First, the fistula opening and all the skin around it are treated with antiseptic agents. Then anesthetic substances are injected into the wound area. At the next stage, the wound is carefully dissected and all pus and remnants of the ligature are removed from it. After this, everything is washed well, drainage is installed and closed with a secondary suture. In this case, the vessels are not sutured, as this can lead to the formation of another fistula. After the operation, the affected person the skin area 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 the fistula, it must be cauterized immediately. Video: Ligature fistula of the perineum.