Fistula - what it is and its causes, symptoms and types, treatment and prevention. Ligature fistula after surgical birth

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 surgery. 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 of the thread with pathogenic bacteria. 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. The main reason for 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 a foreign body enters the body during surgery, it causes infection of the wound. The reason for this inflammation is a disruption in the processes of removing purulent contents from the fistula canal due to the large amount of fluid. If an open wound gets infected, 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. Prolonged presence of a foreign body causes suppuration and subsequent release of pus from the postoperative cavity to the outside. 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 a complete diagnosis. 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 performs 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. A strong immune system 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 agents 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 high-quality treatment, the likelihood of fistula complications is minimal. The occurrence of inflammatory reactions in other tissues of the human body is minimal.

In some cases, a postoperative fistula can be created artificially. 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 has a strong immune system, then the fistula can heal quickly, and no inflammatory complications are observed. It can self-destruct in very 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 the external environment, pleura or internal organs. They occur in the postoperative period as a consequence of bronchial stump failure and necrosis. This type of bronchial fistula is a common consequence of pneumoectomy due to lung cancer and 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 barky cough – sometimes a small amount of sticky mucus 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 an unpleasant fetid odor, severe 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 involves a high risk of complications, including pneumonia, blood poisoning, internal bleeding, and 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, this 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 and sanguineous fluid from it. When the outlet is blocked with pus, the inflammatory process significantly intensifies. When inflammation increases, 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. A long course of the pathological process can contribute to the transition of the fistula into a 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 pathological channel connecting two hollow organs or a hollow organ with the external environment. In the human body, a fistula can form spontaneously or after abdominal surgery. Treatment of fistulas is a long and labor-intensive process that requires highly qualified physicians and patient compliance with all prescribed recommendations.

Classification of fistula openings

By origin:

1. Congenital - those that are diagnosed in infants immediately after birth.
2. Acquired – formed during the patient’s life.

In relation to the external environment:

1. Internal - the fistula canal connects two internal hollow organs.
2. External - the fistula opening creates a connection between the cavity of the internal organ and the external environment.

According to histological structure:

1. Granulating fistulas - the walls of the fistula opening are completely covered with granulation tissue, granulations are constantly renewed and grow.
2. Epithelial fistulas - the walls are lined with epithelial tissue, but the connection with the epidermis of the skin is not formed.
3. Lip-shaped fistulas - the walls and mouth of the canal are lined with epithelium, which connects to the epidermis of the skin, and therefore there is no defect on the skin.

According to the nature of the discharge:

1. Mucous.
2. Purulent.
3. Urinary.
4. Feces.
5. Salivary.
6. Biliary.

There are also natural and artificial fistulas. Natural ones arise independently after surgery or as a result of purulent inflammation of the organ. Artificial ones are created by the surgeon as a temporary measure for nutrition or at one of the stages of treatment.

Causes

The main cause of natural fistula tracts is purulent inflammation of an internal organ or skin. When a foreign body or infection enters the cavity of an internal organ, inflammation and suppuration occur. As the amount of purulent masses increases, the overlying layers gradually melt. As soon as the inflammation moves to the upper layers of the skin, pus breaks out, which creates good conditions for maintaining inflammation and outflow of pus. Healing of the wound edges becomes impossible due to the constant circulation of exudate, which requires surgical treatment.

Important! In the vast majority of cases, a fistula occurs as a complication of surgery. The causes of postoperative fistula tracts are associated with suppuration of the suture material and infection in the wound cavity - this is the so-called ligature fistula. Both skin wounds and internal organs can become inflamed. The deeper the infection, the longer and more difficult it is to treat the fistula.

Signs and symptoms of post-operative and natural fistula ducts

The clinic is quite pronounced and is represented by the following symptoms:

1. An inflamed scar or ridge is visible on the skin, hot to the touch, painful on palpation. The roller may appear in the area of ​​both intact skin and in the suture area.
2. In the center of redness and inflammation, a small hole is visible, from where a large amount of purulent masses and exudate are constantly released.
3. The patient is concerned about the symptoms of intoxication: increased body temperature (up to 38-39C), headache, weakness.

Important! To prevent the formation of fistulas in case of inflammation of a postoperative suture or scar, you should immediately inform your doctor about this.

Why is the appearance of a fistula dangerous?

Ligature and other types of fistulas support a constant inflammatory process in the body, which subsequently leads to the formation of an abscess, phlegmon and organ necrosis. In addition, intoxication persists for a long time, which suppresses the immune system. The patient becomes more susceptible to various infections.

Rectal fistula

In clinical practice, the most common fistula openings are those passing through the wall of the rectum. The mouth of pathological canals can open on the skin (connecting the rectum with the external environment), in the vagina (connecting the rectum with the vagina), in the subcutaneous fat.

Rectal fistulas can form independently and after surgery.

• Independent formation occurs against the background of advanced untreated inflammatory processes (paraproctitis, hemorrhoids) and after a difficult birth, complicated by a 3-4 degree rupture of the perineum.
• Postoperative fistulas – after an incorrectly performed operation for hemorrhoids or paraproctitis.

Ligature (postoperative) fistula

It is a direct complication of the operation and is formed when a suture is unprofessionally applied to the wound and when medical recommendations on lifestyle in the postoperative period are not followed.

The trigger point is infection entering the wound, as a result of which the stitches become inflamed and suppurate. Softening and melting of the edges of the wound leads to the formation of an inflammatory capsule around the sutures. After a few days, the ligatures slide off, creating an artificial opening for the penetration of infectious agents into the wound cavity. Constantly maintained inflammation does not allow the edges of the wound to stick together; the fistula tract epithelializes over time - a full-fledged fistula is formed.

Fistula tracts of the rectum are usually classified by location. There are transsphincteric, extrasphincteric and intrasphincteric fistulas.

It is important to know! With good drainage and outflow of exudate, the symptoms of the disease may not bother the patient for a long time. The patient does not notice that he is sick.

Pain occurs only when pus accumulates in one of the pockets, subcutaneous tissue or in the rectal cavity. This causes symptoms of intoxication (fever, weakness), which further increases the pain. The skin of the perineum turns red and thickens. The patient cannot go to the toilet, sit or walk for a long time, as this increases the pain syndrome.

Fistulas after abdominal surgery

Surgeries on the abdomen are divided into abdominal (with penetration into the abdominal cavity) and superficial, minimally invasive (do not affect the abdominal cavity, surgical manipulations are performed on the surface of the abdominal wall). The most severe cases are deep postoperative fistulas that form after abdominal operations.

• Cavity fistula tracts include fistulas after appendicitis, intestinal obstruction, and liver abscess. For several weeks, pathological anastomoses are formed, characterized by pain. Treatment depends on the presence or absence of a purulent focus of infection in the wound. During the operation, old ligatures are removed, the walls of the fistula tract are excised, and new sutures are applied.
• Superficial fistulas connect the subcutaneous fatty tissue with the external environment and do not affect the abdominal cavity, and therefore their treatment does not cause great difficulties. This group includes fistulas that form after surgery for an umbilical hernia or a hernia of the white line of the abdomen. The treatment is one-stage, one-step excision of suppurated tissue and skin grafting is performed.

External urethral fistulas

A common pathology in childhood is hypospadias. This is how medicine refers to a congenital malformation in which the opening of the urethra is located not at the top of the head of the penis, but on its lower surface. As a rule, the malformation is combined with other anomalies of the genital organs, which requires complex surgery.

Fistula after hypospadias surgery is a common complication. A fistula connects the urethral cavity to the external environment, making urination impossible. Treatment of this pathology begins with minimally invasive techniques: cauterization with silver nitrate. Fistulas of microscopic diameter can be treated this way. If conservative treatment is ineffective and if there is a large fistula, surgery is performed.

Treatment

Treatment is only surgical. Patients are shown an operation during which the walls and mouth of the fistula canal are excised, after which the resulting wound is sutured. If the fistula connects the cavity of the abscess with the external environment, then first the purulent focus is sanitized, and the wound is treated in an open manner. The last stage is to close the pathological anastomosis.

1. Combating constipation - include as many vegetables, fruits and berries (prunes) in your diet as possible. Avoid irritating foods and carbonated drinks that contribute to constipation.
2. Hygienic procedures for the wound surface are carried out daily. Cleaning and disinfection of seams must be carried out every day.
3. Heavy physical activity and long sedentary work for at least three months are excluded.

Diet after fistula surgery

The main guarantee of successful treatment and prevention of recurrence of fistulas is the fight against constipation and facilitation of bowel movements. Any tension in the abdominal wall and an increase in intra-abdominal pressure contributes to the divergence of the sutures and the formation of a repeated ligature fistula.

The diet includes foods rich in fiber: vegetables, berries, fruits. Prunes, boiled beets, and vegetable juices have a good laxative effect. You need to drink at least 2.5 liters of liquid per day. At the first sign of constipation, take laxatives.

Important information! To prevent constipation, all gas-forming foods (grain bread, cabbage, legumes, dairy products), carbonated drinks, spicy and other irritating foods are removed from the menu.

Dishes are steamed and vegetables are boiled. This diet promotes rapid recovery and healing of the postoperative scar.

Useful video: How a fistula occurs after surgery

Recurrence of fistulas

Relapse of the disease occurs when diet or hygiene rules are not followed, after heavy physical exertion or after prolonged sedentary work. A relapse is accompanied by the return of all the symptoms that previously bothered the patient. Treatment of relapse is carried out in a surgical hospital. After surgery, it is necessary to pay special attention to compliance with recommendations and lifestyle.

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 the formation of a 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 of a 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 (cesarean 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 tissue, fascia);

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

They have a different development of the 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, the fistula tract will be clearly visible on the x-ray.

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. Complex therapy using medications is used for treatment.

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:

Three-time treatment of the surgical field with an 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.

Stop possible bleeding with an electrocoagulator or hydrogen peroxide 3%, since suturing a blood vessel can 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;

Herbal preparations with vitamin E (aloe, sea buckthorn oil).

Local revision of inflamed tissues with wide dissection of the fistula is a classic form of surgical treatment of 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 a 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 from the source of inflammation. You can see the fistula at the projection site of the tooth, in its upper part. It looks like a sore spot.

A perirectal fistula occurs as a consequence of metabolic disorders 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 discharge, pain, itching, and 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 the closure of 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 reducing 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 a reliable sign that after the operation a fistula has formed and the process of its rejection has begun. 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.

The presence of cancer that depletes 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:

They 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.

They have various 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 is the spread of purulent formations under the skin through 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

A ligature fistula can be identified by visiting the dressing room during a clinical examination of the postoperative wound. Also, if you suspect the development of a ligature fistula, you should undergo an ultrasound examination of the wound 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 with a wide spectrum of action - 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.

If there is abundant discharge of purulent masses from the fistula, it is strictly forbidden to use fatty ointments (syntomycin, 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 option for treating a ligature fistula is a generally accepted standard, because eliminating the cause of constant suppuration can only be achieved through surgical treatment of a postoperative wound with a complication that has arisen 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;

dissection of the wound and complete removal of 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. If there is no purulent discharge, the drainage system is removed. 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, surgical intervention will still be required to treat the fistula, but this will waste time, which may be enough for the development of complications that are life-threatening.

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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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 with 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.

A fistula at the suture after surgery forms a compaction of 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 not difficult to recognize a fistula after surgery by its characteristic symptoms. 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, at the 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 experience such symptoms, you need to see a doctor immediately, otherwise the infectious process may spread to your 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 of 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 one will show the presence of hydrochloric acid, and the uric one will show 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, it is first necessary to:

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 a vitamin complex so that you have more strength to fight germs.
5. The wound is washed with a syringe with hydrogen peroxide or a furatsilin solution, as these agents are excellent disinfectants and promote rapid 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 equal quantities of 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.
• It is necessary to treat all 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 the 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 during the patient’s stay in a medical facility, 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. The 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 - its 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 volume of discharge may be insignificant, but with a rapidly developing process, noticeable weeping may be observed.
• 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 a ligature fistula must begin as soon as possible, since this is a serious complication that can lead to secondary infection, disability, and in severe, advanced cases, sepsis, which can lead to death for the patient. 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 has been 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 the 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

A fistula, or fistula (from Latin - “tube”) is a channel connecting hollow organs to each other or to the external environment, or connecting a cavity or surface of the body with a tumor. The fistula looks like a narrow canal, covered with the top layer of skin - the epithelium.

There are fistulas that are the consequences of pathological processes and fistulas that are the consequences of a surgical operation performed to drain the contents of a hollow organ.

It is considered a complication after surgery. Typically, a fistula occurs as a result of suppuration, eventration or infiltrates of surgical scars. The main reason for the occurrence of a postoperative fistula is contamination of the suture material (ligature, or ligature thread) by pathogenic microorganisms. A compaction (granuloma) forms around the fistula, which consists of the ligature thread itself and cells with fibrous tissue, macrophages, collagen fibers, etc. The fistula can be small in size and not cause any inconvenience.
Fistulas most often occur as a result of the use of a special silk thread.

Symptoms

The development of a fistula has its own distinct symptoms.

• Seals and mushroom-shaped granulations (tubercles) that are hot to the touch form around the infected area of ​​the sutured wound.
• A limited area of ​​the postoperative scar becomes inflamed.
• A small (less often large) amount of pus is discharged from the wound.
• The place is redder.
• Swelling and pain appear in the area of ​​the fistula.
• Body temperature rises to 39 degrees.

Consequences of fistula

Sometimes the suppuration reaches a significant size and does not go away for a long time. The result of suppuration of the ligature thread can be an abscess. In such cases, ligature fistulas can secondarily infect a postoperative suture or lead to intoxication of the entire body, including disability. Frequent discharge of pus from the opening of the fistula can cause dermatitis.

Postoperative ligature fistula can occur several months after surgery.

Treatment of postoperative ligature fistula

Sometimes the ligature thread festeres and comes out with pus on its own. But you should not wait for such a moment; it is better to immediately seek medical help and treatment.

This treatment cannot be carried out independently at home. It can and should only be carried out by a specialist.
Treatment of a fistula most often involves surgical removal of the suppurating ligature thread. After this, the patient undergoes a course of drug treatment with antibiotics or anti-inflammatory drugs. In addition, doctors recommend taking vitamin complexes to strengthen the immune system. To speed up the healing of the wound, its sanitation is done by washing it with a solution of furatsilin or hydrogen peroxide, which perfectly neutralize the surface and wash away the released pus.

In addition to removing suppurating ligatures, excess granulations are also cauterized or scraped out.

There is also a more gentle way to treat postoperative fistula - ultrasound.

If several fistulas have formed, complete excision of the postoperative scar, removal of the infected ligature thread and re-suturing are prescribed.

Prevention of fistula after surgery

Such prevention depends on the surgeon, who must carefully observe all aseptic measures during the operation. The suture material must be sterile, and the wound must be washed before suturing. It is better to use modern absorbable threads - such as Vicryl, Dexon.

Fistula after cesarean section is one of the most common problems, which is directly related to the operation and is dangerous because it provokes the entry of various pathological microorganisms into the female body, which stimulate the development of infectious processes.

After any operation, special sutures are applied to promote rapid healing. Doctors process the incision to stop the bleeding in time and prevent massive blood loss. The material of all seams is ligature. It does not cause women any further complications.

Before stitching a cut, experienced specialists carefully treat it to prevent bacteria from getting inside. If you do not do this, inflammatory processes will develop, which will provoke the appearance of a fistula. Any penetration into the suture material causes the formation of pus. It subsequently flows out, the passage is called a fistula. The fluid can make its way into one hole or into several, so many ligature fistulas can appear simultaneously.

Photos of fistulas after cesarean

The complication develops within 4 days after a cesarean section, up to several months. When the inflammatory processes pass, the fistulas close for a while, but recovery will not occur until doctors eliminate the source of suppuration.

Definition of fistula

A fistula is an opening in the form of a passage connecting certain openings in the body, organ systems with each other or with the environment. It looks like a narrow slit, which is lined with fabric. Fistulas are formed as a result of suturing after operations, as well as due to inflammatory processes occurring inside the human body.

Purulent fluid is formed due to the cessation of inflammatory processes. The hole through which this fluid flows out then heals completely. But if the infection is not completely suppressed, this canal does not heal and a purulent fistula is formed. Fistulas often form, which directly proves the development of pathological microorganisms inside a person. Any neoplasm is nothing more than the body’s reaction to the development and reproduction of these pathogens. If fistulas are detected, you should immediately seek the help of experienced specialists so that they can carry out the necessary diagnostic measures and recommend how to properly treat this disease.

Important! Self-medication is not recommended, it can harm your health.

Causes of ligature fistula

A ligature fistula forms after a cesarean section for a number of reasons. These are often:

• infections entering the body through sutures;
• insufficient treatment of the cut;
• violation of antiseptic rules during surgical procedures;
• the appearance of allergic reactions to special materials used to stitch the wound;
• age limits;
• general condition of the woman;
• immunity;
• presence of chronic diseases;
• the formation of inflammatory processes associated with seasonal diseases;
• bad equipment;
• consequences after cancer;
• lack of useful minerals in the body;
• presence of diabetes mellitus;
• excess weight;
• metabolic disorder syndrome;
• inflammation in the oral cavity.

Fistulas often appear due to postoperative scars. Unsanitary conditions, enormous physical activity, stressful situations, the use of expired patches and bandages, poor diet and bad habits also have a beneficial effect on the development of purulent fistulas. If treated immediately, further complications may develop that will affect the woman's health and performance.

Symptoms of fistula after cesarean section

Signs of a fistula on the suture after cesarean section are the following:

• in the first days there is a sharp thickening of the suture area and its redness. Doctors may observe slight swelling and a slight increase in body temperature;
• after 7 days, liquid emerges from the sutures with strong pressure and palpation, and subsequently a purulent compound;
• on the 10th day a febrile state appears, body temperature increases to 38°;
• fistula canals become clogged on their own, but when inflammatory processes occur, they open again;
• the appearance of a hole in the skin;
• hot area around the seam.

Fistula openings are always accompanied by the appearance of a slight temperature. At the earliest stages this rise is insignificant, but This condition cannot be ignored; it is better to consult a doctor immediately to start treatment on time. It is very difficult not to notice a fistula, all symptoms quickly appear, and recognizing a neoplasm is quite simple. Typically, after a caesarean section, the doctor often examines the patient and observes how the stitches are healing, so he will very quickly detect infection and the development of inflammatory foci.

Treatment of ligature fistula

Before starting treatment, every woman should understand that getting rid of a ligature fistula can only be done through surgery. Prolonged delay in treatment can lead to a number of complications. Treatment includes taking the following medications:

1. Antiseptic agents with local anesthetic effect.
2. ampicillin group.
3. Enzymes that can quickly dissolve dead cells.

These medications need to be introduced into the fistula canal and peripheral places at certain intervals, because their effect lasts for 5 hours.

It is important to know that if there is a strong discharge of purulent fluid from the fistula, it is forbidden to treat the incision with greasy ointments, because they clog the passage of the canal, which contributes to the further spread of infection.

If the inflammatory process is severe, you can resort to other treatment methods - physiotherapeutic procedures. Experienced specialists recommend quartz wound. The procedure helps reduce swelling and improve the patient's condition. But such measures can only stop the development of the disease, cure it completely - in no case. Only with the help of surgical intervention can you get rid of the cause of constant suppuration. This disease cannot be treated at home.

Attention! Before taking any medications, consult your doctor!

Preventive actions

Doctors cannot guarantee 100% safety during and after surgery. Many infections penetrate inside quickly and deftly, so there are no exact preventive measures. But experts advise adhering to the following rules:

• you need to stop using thick silk threads to stitch the incision;
• after a cesarean section, use only synthetic threads;
• strictly follow aseptic measures;
• For speedy healing, take medications prescribed by your doctor.

To prevent the appearance of a fistula, you should properly care for the sutures, do dressings on time, take medications, lead a healthy lifestyle and eat right. Any deviations from the norm can provoke the development of pathology, even the appearance of diseases that are in no way related to gynecology and the urinary system: problems with the heart vessels, the gastrointestinal tract system and mucous membranes.

What do doctors think?

No doctor can fully guarantee that the operation will not lead to adverse consequences. Ligature fistulas appear due to the penetration of infectious microorganisms into the incision. Experts recommend immediately combating the pathology, because it can provoke the development of further complications and lead to sepsis. Therefore, you should definitely consult a doctor if you have fistulas after a caesarean section. It is very easy to detect; doctors advise paying attention if a seal appears around the wound and infiltrate.

All seals become hot, because this is due to the infection process. Redness will always be visible near the scar, at first small, then huge. During surgical interventions, the wound often festers and all its contents come out. It is also necessary to monitor the fact that these processes can provoke the appearance of swelling of peripheral tissues. Experts recommend not remaining silent about the development of fistulas, because they require immediate treatment. Surgeons may decide to operate again to completely cure the woman. To do this, they will use only thin surgical threads made of synthetics.

Conclusion

Fistula after cesarean section requires mandatory treatment. The patient is obliged to contact a specialist in a timely manner so that he can prescribe a number of necessary examinations and tests. Only an experienced specialist can prescribe treatment; all preventive and diagnostic measures are carried out only in a hospital. Treatment can be conservative or surgical. Most often, fistulas are removed surgically, after which the woman is prescribed antibiotics. The wound always requires special careful care. For this purpose, formulations are purchased; they help cleanse the wound of purulent fluid and avoid subsequent infection. Doctors recommend the use of hydrogen peroxide and furatsilin.

Conservative therapy helps when the process of fistula development has just begun. Doctors are trying to remove dead tissue around the inflammatory focus and completely wash out the pus. Often those threads that come out and provoke the growth of fistulas are removed. After getting rid of pathology The patient is prescribed a course of antibiotic therapy and complex vitamins.

To avoid ligature fistula, it is important to properly lubricate the wound, both before and after suturing. Doctors are required to work only with sterile materials. When the first signs of pathology appear, they must provide timely medical assistance. In most cases, the outcome of the disease is favorable.