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Fistulotomy Won’t Heal - Advice?

I have perianal Crohn’s disease and developed an abscess in August of this last year. When the abscess drained I was left with a superficial fistula. My doctor performed a fistulotomy to “lay it open.” He told me because my Crohn’s disease is located in the anus that it would take a “long time” for my fistulotomy wound to heal. Immediately after the surgery surprisingly I had no pain. I thought I was in the clear. Boy was I wrong. It’s been almost 3 months since my surgery and I have this open wound that will not heal. It is not infected but it is very inflamed and hurts when I have a bowel movement. My colorectal surgeon told me to keep is as dry as possible with blow drying and cotton pads to promote healing. This is very difficult because the mucus drainage is constant. After bowel movements it’s worse. I use a bidet, sitz baths, toilet paper, hair dryer, and cotton pads to keep the area clean and as dry as possible. The amount of cotton pads I use down there has significantly increased in the last 2 months because of drainage. I’ve tried metronidazole cream with no help. I’ve been recommended silvadene, colloidal silver cream, even Manuka honey to put down there but have yet to try. Anyone have any luck with any creams or treatment that lead to healing for a wound like this?
 
I have perianal Crohn’s disease and developed an abscess in August of this last year. When the abscess drained I was left with a superficial fistula. My doctor performed a fistulotomy to “lay it open.” He told me because my Crohn’s disease is located in the anus that it would take a “long time” for my fistulotomy wound to heal. Immediately after the surgery surprisingly I had no pain. I thought I was in the clear. Boy was I wrong. It’s been almost 3 months since my surgery and I have this open wound that will not heal. It is not infected but it is very inflamed and hurts when I have a bowel movement. My colorectal surgeon told me to keep is as dry as possible with blow drying and cotton pads to promote healing. This is very difficult because the mucus drainage is constant. After bowel movements it’s worse. I use a bidet, sitz baths, toilet paper, hair dryer, and cotton pads to keep the area clean and as dry as possible. The amount of cotton pads I use down there has significantly increased in the last 2 months because of drainage. I’ve tried metronidazole cream with no help. I’ve been recommended silvadene, colloidal silver cream, even Manuka honey to put down there but have yet to try. Anyone have any luck with any creams or treatment that lead to healing for a wound like this?
I can sympathise because I use a portable bidet after bowel movements and moist toilet wipes also. Talc, ointments and sanitary pads. Toilet paper can irritate so I would just dab, not wipe. Wiping from back to front causes urinary tract infections due to bacteria in the faeces. I would go back to see your surgeon and ask for a second opinion. I had mine stitched and have a scar in my bum. Nice ...
 
Hey there,

I had two fistula surgeries (ten years apart, the first was a fibrin glue plug) and followed this protocol and both times at the one week follow up the surgeons exclaimed that it was healing much faster than expected:

- Get a tube of Povidone iodine marketed as "Betadyne". This is an amazingly good antibacterial, it penetrates the skin, and has no known side effects. [1], [2].

- Get a set of disposable surgical gloves from your local pharmacy. Wear a glove. Take a blob of the Betadyne on a finger and irrigate the external wound. Take a second blob of the Betadynea and smear it into the rectum and anal canal, try to reach the erstwhile internal opening of the fistula. (Use some TP to wipe up everything outside the wound this stuff will stain your clothes, I had some TP in my shorts too for good measure)

- Repeat this betadyne routine twice a day, once before sleeping, and once in the morning after your shower.

- Important: After taking a poo, at all times follow up with a shower (make sure you have a hand held shower), and the Betadyne routine. 2. Also, try not to sit. At all. After my surgery I just didnt sit down on my arse for two or three weeks till the thing healed completely. Its possible!

Hope this helps.

[1] https://pubmed.ncbi.nlm.nih.gov/12011534/
[2] https://www.sciencedirect.com/science/article/pii/S1743919117305368
 
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