Not certain where to go on from here with an Abscess

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Kancer

Kancer

Joined
Jun 24, 2015
Messages
120
Exactly 8 days ago, I had an abscess drained at the hospital. I was hospitalised for 2 days and was discharged. I have been having the wound packed and dressed daily. My follow up for the abscess is a month from now and till then, I need to have my wound packed.

I am still having some discharge from my wound. It is pale green. I was told the depth is no more than 2cm. I would like to know how long does it take to heal the wound. I have increased my Vitamin C intake and eating extremely healthy to promote healing. I would really appreciate advise regarding wound care and How Long Can it Take for the Wound to Heal?

Thanks in advance!
 
Thank you. I can not find how long does it usually take for the wound take to stop draining? I understand for a wound to heal and form scar tissue, it may take 1-2 months or more. However, I am not certain as to how long it will take for the draining to decrease. I do notice decrease in the drainage but other's personal experience would help with my mindset.
 
Hi there. I had surgery the first of November for fissures and hemi and develeoped abscess/fistula. I noticed it around the middle of November beginning and had surgery to drain it on the 23rd. I was in the hospital for 4 days with mine. They packed it and I had to learn to repack...took until the second week of January for mine to stop draining and begin to close. I went for a check up three times to monitor it, last time was yesterday. The color was green as well, and had some bleeding as well for part of it. Mine was perirectal, so I had to shower/sitz after every bowel movement. I changed my packing every time I used the bathroom to help keep it clean. I also used extra gauze to catch any extra drainage...clean eating, lots of water, and lots of rest were some choices I made. I was off work for 7 weeks to allow it to heal before I ventured back to work. Good luck!
 
Lisadc1,

Great advice! I had packing for the same thing but never learned , or was taught how to do it. I think these doctors and nurses need to bring more of us up to speed so we know what to do.

I think you are very helpful and a really kind soul. Good on you!

I like your style!

cmack
 
Hi Cmack,

The new abscess was drained 13 days ago and I am still healing. I was put on 40mg prednisone to control my flare and am currently on Amoxicillin and levofloxacin to be on the safe side of things while the wound is healing. Since I am taking steroids as well, the Gi thought its better I take antibiotics for another 5 weeks in order to avoid infection.

I have a 5cm deep wound and sometimes pass gas through that wound. Does this confirm a fistula?
 
Hi Kancer,

I hate to say it but here is a hole in there somewhere. I had the same kind of thing. It likely is a small fistula.(may require minor surgery.) Tell the doctor. They may may put a suture or a seton in to make it heal better. Believe me it pays to mention this stuff. They don't usually heal themselves without surgery. Take 5 minutes out of the surgeons day and tell him everything that you think is important(make a list of questions.)I found telling/asking nicely, of them to only do what they would feel comfortable doing to a family member of theirs or to themselves made a difference. I would say it on the operating table to all of them especially the surgeon.

hope this helps,

cmack
 
Abscesses have a mind of their own. I'm on a permanent colostomy now after having had multiple abscesses through my 30's and early 40's before going under the knife for the big one leaving me with The Bag. I'm just short of 60 today.
I had some that healed up well, and some that healed well and were about to close when they would open back up with inflammation and take in more packing. My specialist then explained that CD was active.
After several rounds of treatments, Aza and Cipro got things back under control. Cipro went against me, and I had to come off of the meds to give my liver and kidneys a rest. Crohn's today is under control, but I have to mind the strictures and chew my food well.
 
Thanks Bufford for your input. I had a colonoscopy done last month which showed multiple ulcers and a deformed IC valve but I was told it is not deformed to an extent that requires surgery. I have been on Pentasa and Steroids periodically but now the GI wants to me to go on Azathioprine to stop further damage as he doesn't want me to come to a state where I require surgery.

He has put me on 40mg pred for 6 weeks for my Crohn's to calm down and start Aza once things look good. As I also have 2 open wounds from I&D, they don't want my immune system to be extremely compromised.

Went in to see my surgeon today and he thinks the wound is healing nicely and I mentioned that I sometimes pass gas through the open wound and he mentioned I might have a fistula and requested an MRI (scheduled for June) to find out if I have fistulas. He doesn't want to do any surgery for at least 6 months and see how things go first as it is not causing too much disturbance.

Out of curiosity, when I had a fistula 4 years ago, it healed on its own without any intervention or medication. Can I safely assume I have some chance it might heal on its own?
 
I would have it monitored. I had an abscess that drained and healed once on it's own and I had a fistula that healed once on it's own but most of the time they have needed surgery.
 
Fistulas will sometimes heal over, the problem is that they sometimes cannot drain, or they reopen with recurring flares. These can lead to future abscesses. I've had some that went away on their own, but its that one that goes wrong that we are all scared of.
 
Bufford said:
Fistulas will sometimes heal over, the problem is that they sometimes cannot drain, or they reopen with recurring flares. These can lead to future abscesses. I've had some that went away on their own, but its that one that goes wrong that we are all scared of.
Click to expand...

This is exactly right Bufford. Ron is right too. They should monitor them. It can go sideways in a hurry. I hope it heals on its own.
 
My own personal experience is that I had an abscess drained at the hospital Sept. 2015, spent one night in the hospital, and then was out of work for several weeks with pain. Saw my Colon-Rectal surgeon regularly, and the abscess didn't heal but instead turned into a fistula. Eventually had surgery on the fistula. Fistula healed, pretty much, but still having issues. Am using Humira but if things don't get better will discuss changing treatment with my GI doctor.

I used folded gauze pads to catch any drainage, and also Calmoseptine lotion.

Basically, everyone is different and how quickly and well the abscess heals depends on the level of your Crohn's and will indicate future treatments.

If you are seeing a Colon-Rectal surgeon they can monitor the healing, there is a scope that they use (fun, fun, fun!) and you should be going on a regular basis (every month or so I'd expect.)
 
I had the packing/dressing done today for the 5cm deep wound. I was told the depth is now 3-4 cm and it has only been 15 days post-op. The nurse cleaned the whole tract with a syringe (Something to suck out any liquid deep inside) and remarked that there was only clear liquid and no pus inside.

On the bright side, I have no pain whatsoever in the wound when packing/dressing/sitting which I am extremely grateful for. I haven't been taking any pain killers for nearly a week and so far, I feel like I have been taking on my normal activities slowly. (Only annoying part is having to remove the dressing multiple times a day after bowel movement since I have 2-3 normal BMs a day).

The nurse said the tract is clean so I think I may just have an extremely small fistula that allows gas to pass but not the stool (I hope).
 
Hi guys,

It's me again. I am a bit worried as my old wound (2 months old since I&D) still hasn't healed - There is no drainage from it however the skin just wouldn't close and look like there is a crack on the skin. Is it to be expected as this is the first time in my entire life I have had any wound like this.

Would things heal faster if I were to drop from 40mg to 30mg prednisolone? I was originally supposed to be on 40mg for 4 weeks but since the hospital system could only reserve an appointment with my GI earliest after 6 weeks, I was put on 40mg 6 weeks. I never had much issues tapering but I was wondering if it makes any difference to the body at 30mg or 40mg since this is essentially 3-4x the normal hormone level.

Thanks again
 
I had a large abscess, and it took 3 1/2 months for it to heal completely. I think we heal slower with Crohn's. Protein is necessary in healing, you could try upping your protein intake. :ghug:
 
Keep an eye on it, with CD wounds often heal up erratically and are less predictable. They try to heal over and often open up and can look quite angry again, rising and falling with the tidal influence of the flare cycles with in the disease itself. The best you can do is avoid allergy triggers, keep the area clean, manage the pain, pay attention to changes and hope the meds will help.

There seems to be flare cycles involved in CD that are somewhat like the weather, the shorter smaller flares. Then there are the longer cycles that are more like seasons. These are the longer and more severe ones that doctors often try to quell using various treatments.
 
Checking in again. I noticed the wound has healed a lot and is substantially smaller. I was taken off Antibiotics after 6 weeks of use and decreased my prednisone dose from 40mg to 20mg (Still tapering every 2 weeks to eventually 5mg and done) and started on 50mg Azathioprine.

I have been of antibiotics for about 4 days now and I am noticing increased Pus from the abscess wound (I know its a fistula there now but doctors want to confirm it via MRI in June as I am on a waitlist). The pus leak was decreasing for a while as I tapered off prednisone but since I came off antibiotics, it seems to have increased a bit.

Can I assume its part of the normal healing process? I have no issues with the wound site other than the leak. It feels like there is no wound other than the irritation of having a dressing there. I was put of Azathioprine 50mg as it has a chance to heal the fistula and maybe gradually increase the dose depending on how i react to it. Today is my 3rd day on Azathioprine.
 
There might be active infection still going on if its showing signs of puss. I'd keep a close eye on it and call the doctor if it suddenly changes. If the fistula can drain it should remain stable, if it gets plugged it will suddenly blow up into an abscess.
 
Bufford said:
There might be active infection still going on if its showing signs of puss. I'd keep a close eye on it and call the doctor if it suddenly changes. If the fistula can drain it should remain stable, if it gets plugged it will suddenly blow up into an abscess.
Click to expand...

May I know what you mean by active infection? As in the gland is still infected? It has been 7 weeks post-op. I would also like to clarify whether the liquid coming out is actually Pus. It is green in colour.

I saw a post on this thread earlier than their fistula was draining for 3.5 months. Sometimes I have to squeeze the pus out by pressing on the wound.
 
ronroush7 said:
Call your doctor and tell him what is happening.
Click to expand...

I would not be able to call him at all due to how the hospital system works here. I have to go to the A&E for consultation. The drainage isn't really physically affecting me other than having to change the dressing.

I have an appointment with the surgeon next Thursday. I have to wait till then to clarify my doubts. In the mean time, I think I will go to the local nurse to check whether what I am having is pus or just form discharge. May I know how I can differentiate pus from wound discharge as my incision was pretty deep
 
Hi Kancer,

It sounds like there is still an ongoing infection. This is common with fistulas and abscess' and needs to be monitored. I would have your nurse look at it. Usually blood work is needed to check white blood cell count to determine the extent of the infection. I ended up with sepsis from something similar(very serious). Normal wound discharge is not usually green, at least not for me it wasn't. If a wound is healing properly usually it oozes yellowish clear or light pink to light red at times. That is my experience.

Make sure to get answers about this. I would hate for anything to get worse for you.


Best wishes,

cmack
 
My abscess took about a month to fully heal. Remicade really helped the healing process, I'm not sure if you're on a biologic or not. Another recommendation I have is to check out B-sure anal pads, they're great. They are easy to use and very effective! Look for them on Amazon, they aren't super cheap but I think Amazon gives decent deals on them if you buy them in bulk.
 
I would have it monitored. I had an abscess that drained and healed once on it's own and I had a fistula that healed once on it's own but most of the time they have needed surgery.
 
I went to the local nurse for dressing and she mentioned the wound is clean and nearly healed but there is still pus coming out of the fistula.

Now my question is could it be possible he prednisone I am taking is making the fistula healing slower? Or at least keeping the drainage going. I have been on 40mg prednisone for nearly 7 weeks (right after the surgery was performed) to control my flare. Currently tapered down to 20mg. Since prednisone lowers WBC, is it possible that this is still draining due to the prednisone.

Plus, it is normal for a fistula to drain pus right? Or should the discharge not be pus? I would honestly appreciate as many feedback as possible. I am a bit worried now
 
Green discharge is never a good sign. However, as long as it keeps draining freely you should be able to manage it until you see the surgeon. Keep an eye on it until your next appointment.
 
Another update guys.. I am not entirely sure if I should be worried or happy. I noticed yesterday that the pus draining decreased greatly and I simply thought it was just the usual of one day having less pus and the next day having a lot.

I woke up this morning and when I did my dressing, I noticed my gauge had no pus at all. Or no discharge for that matter. It was as clean as I put it 12 hours ago. I started inspecting the wound and it seem to have closed a lot. The only thing that worries me is that I can see pus in the middle my wound that won't come off even if I wipe it with a sterile cotton.

I can no longer see the fistula hole so I am either guessing it is going to become another abscess or Azathioprine worked and it has healed? Should I go to a local nurse to get it checked? Just don't feel like doing so as it eats up 1.5 hours of my day. Thanks
 
Hey Kancer,

I would be concerned that it is abscessing. If you are not sure, I think you better get it looked at. I hate how fast this disease can pull nasty tricks on us. I wish you the best bud.

Hoping for the best,

cmack
 
Got a bit worried I decided to apply pressure on a wound. Very little pus came out but the blockage is gone. I think the pus might have gotten dry and got stuck in the wound as the wound is getting really small.

From what I am told, the surgeons won't do any surgery until June/July since they want to see if Azathioprine would work on the fistula and wait for the MRI results. Will be seeing my surgeon in 3 days.
 
Hey guys, Checking in again. Good news. The surgeon did an inspection on the wound and thinks that it is unlikely a fistula. The pus that's coming out of the wound is so mild that she thinks its in the final stages of healing and should completely close up in a week or two. Though she doesn't want to confirm anything until the MRI in june.
 
Tuff said:
I had a large abscess, and it took 3 1/2 months for it to heal completely. I think we heal slower with Crohn's. Protein is necessary in healing, you could try upping your protein intake. :ghug:
Click to expand...

Tuff, I need your input on this please. I am just short of 3 months since my abscess surgery and I am still having pus coming out of the wound. It is no longer really a wound as it has stopped healing now. Pretty much no changes in size of wound. Some days there is little pus despite squeezing the wound or applying pressure and some days theres a considerable amount of pus.

The surgeon said it doesn't seem like fistula 2 weeks ago. I am getting a bit agitated now having to put the gauze every day and after every f*#king bowel movement. I just want to stitch this hold shut....

So my question is when you mentioned it took you 3.5 months to heal, were you having pus for this entire period and eventually decreased or "HEALED" as in for the wound to close but still very little drainage.
 
I had a very large horseshoe abscess, but it did not drain very much. It was just so big that it took a long time to close from the inside out.
How large is your wound now? It should be getting smaller if it's healing. I wonder if antibiotics would help, or maybe it does have a fistula hole in it that is draining. The MRI should show if there is one.
 
This is the best way I can describe my wound. It is much smaller than what it was right after surgery. In terms of how big of a hole is left, I would say its almost non existant. Maybe 1mm. However the weird bit is that I can still see my flesh bulging out and the skin is not covering. The skin healing has stopped for a while whereas the flesh has mostly healed except for a small opening where the pus is coming out out.

As for squeezing, I believe getting the pus out is healthy? I am not squeezing as in the typical acne squeeze. I apply pressure to the sides of the wound (like pressing my buttock fat) and it just comes out. I can confirm it is pus as the ER Doc confirms it.

At this stage, I am glad I still have an opening as I don't want to deal with another abscess. My guess is that it might be a fistula? Any opinions?
 
I still wouldn't squeeze it. You could get sepsis. It could be a fistula, in which case you don't want it to close, or you'd get another abscess. They would probably put in a seton to keep it open.
 
Hi Kancer,

I'm not sure, but it kind of sounds like a small fistula. I think you might need a seton of some sort. We seem to always get stuck choosing the lesser of two evils. I feel for you.

My setons helped greatly and I eventually healed up. I have had all kinds of the setons, they were all annoying but the cutting ones produced the best results.


I wish you the best buddy, talk to me any time,

cmack
 

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