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Please help... Not healing right...

So, about two months back, I had a seton put in for a complex perianal fistula. When I was under, my surgeon cut a slice out beside the seton, leaving some skin between the chunk she took out and the seton hole.

Then I was put on imuran! I achieved a good remission (though any stress does numbers on me). However, the imuran is causing my seton and the other missing chunk to not heal. There is alot of irritated tissue around them both, and the skin wall between them is starting to get thinner from seton abrasions.

I've seen my surgeon, and she cauterized both wounds with silver nitrate. It was very painful (sensitive area lawl), and three weeks later, has achieved nothing. I am in pain most of the time. I do the sitz baths.

Can anyone suggest any kind of pro-healing stuff? I don't want to get it cauterized again, as that was alot worse than the seton placement itself. I don't know what to do, and I really just want to rip the seton out D:

Help!
 

Jennifer

Adminstrator
Staff member
Location
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Hrmm, I don't know if this will help or not but I'll share anyway just in case cause I don't know how big the "chunk" is and I never had a seton before either. After my resection my wound where they did the hand assist didn't heal properly and broke back open so the tissue had to heal from the inside out. It was a pretty big gash that gradually became smaller and smaller over a month by being packed with gauze twice a day that had been soaked in a saline solution and then removing the gauze to shower and scrub the wound clean for repacking. The wound gradually got smaller and was eventually about the width of my pinky or less and not very deep at all (maybe a quarter of an inch) yet my mom still packed it with gauze to help it heal fully. This process may or may not help you heal better if you cut the gauze in smaller pieces (depending on the size of your wound) and let it heal from the inside out. You'd have to get the saline solution from your doctor somehow through via prescription I believe. I don't think you can just buy that stuff.

Dunno if that helped or not but its all I got.

Edit: My mom packed it in by using the end of a Q-tip stick that came with the cleaning pack and it hurt but probably not as bad as cauterizing the wound. :p
 
I have the exact same problem with my seton, they left a 'chunk' on the outside of my cheek that they always have to silver nitrate when i see them...yes it soes hurt...(once they over did it and it made the otherside of my bumcheek burnt..ouchies) when i originally came out of theatre they had a 'lollipop' type stick hanging out of this 'chunk' to that i had to leave in for over a week, which was very annoying and sore...
I still get very irritated andd have to wear pads and put creams on to prevent the redness, from the stuff that drains...i still get the feeling of a ball inside which is hurtful when seated and moving....Other than that i don't believe there is too much to do...I understand i loathe having this drain in place and i don't feel like its doing much...i want to rip the thing out an be gone with it, but the thought of another nasty abcess, makes me change my mind....Its also the fact that i have lost a lot of self confidence since having this in and that sucks the most...I understand totally..sorry i couldn't help fully...
Bec x
 
heya,
i don't have any experience with a seton but i've had two incision and drainage procedures on a perianal abscess and after both surgeries i had wound packing similar to what CrabbyRelish is talking about. i saw a district nurse daily after both my surgeries for about a month each time but instead of saline-soaked gauze they used an alginate dressing. its made from seaweed (i have no idea how though?? haha) and is supposed to promote wound healing. the nurses actually all sorts of different fancy dressings to choose from. wound packing might only be for deeper wounds though, although the nurse told me that generally they try to pack wounds until they're 5mm deep.
so if that sounds like it could be helpful maybe your dr could refer to a wound specialist nurse or something similar?? i'm from NZ so its probably different here but my hospital has a daily wound dressing clinic which is run by district nurses.

oh and as well dressings etc the nurse i saw told me to make sure i was getting enough protein in my diet and she said that there's some evidence that taking vitamin C helps wound healing.

i hope you find something that helps soon!

kate
 
Wound packing isn't really and option. The incision is about a canadian loonie in circumference, and about three loonies stacked in depth. My surg said that packing would just fall out :eek:
 
I have the exact same problem with my seton, they left a 'chunk' on the outside of my cheek that they always have to silver nitrate when i see them...yes it soes hurt...(once they over did it and it made the otherside of my bumcheek burnt..ouchies) when i originally came out of theatre they had a 'lollipop' type stick hanging out of this 'chunk' to that i had to leave in for over a week, which was very annoying and sore...
I still get very irritated andd have to wear pads and put creams on to prevent the redness, from the stuff that drains...i still get the feeling of a ball inside which is hurtful when seated and moving....Other than that i don't believe there is too much to do...I understand i loathe having this drain in place and i don't feel like its doing much...i want to rip the thing out an be gone with it, but the thought of another nasty abcess, makes me change my mind....Its also the fact that i have lost a lot of self confidence since having this in and that sucks the most...I understand totally..sorry i couldn't help fully...
Bec x

I have to do the creams too. Polysporin seems to help it heal, but it also causes pimples in places there definitely SHOULD NOT BE PIMPLES.

My drain works good. A little too good. But the pain from the open wounds equals that of the abscess pre-procedure.

I know about the self-confidence issue. I bought an air ring the other day, and it works great. I have my graduation ceremony on friday, and i'll have to sit on a wooden bench for three hours. I'm too embarassed to bring my donut :S I don't even think of the sexual reprecussions.
 

Jennifer

Adminstrator
Staff member
Location
SLO
Wound packing isn't really and option. The incision is about a canadian loonie in circumference, and about three loonies stacked in depth. My surg said that packing would just fall out :eek:
Well you put a patch over it so there's no way it would fall out. Forgot to mention that part. :p Even though its deeper than it is wide (I don't know how big that coin is but I'm guessing around the size of a dime here in the states) I still think it could work if done right. One piece of gauze would be long enough to stick in there and the length would make it easy to pull back out. Like a piece of string that slowly gets mashed into a ball.
 
Well you put a patch over it so there's no way it would fall out. Forgot to mention that part. :p Even though its deeper than it is wide (I don't know how big that coin is but I'm guessing around the size of a dime here in the states) I still think it could work if done right. One piece of gauze would be long enough to stick in there and the length would make it easy to pull back out. Like a piece of string that slowly gets mashed into a ball.
That's sounds disturbingly painful... Especially having it repacked.. Wouldn't that require metal utensils? I have beef against metal being in my body :S A loonie is actually bigger than an american quarter haha... So did it help you heal? I mean, that'd be cool. But I still have the problem that it is a very complex fistula, like a tree, and the fistulas haven't even closed up yet. So there isn't really any point to the actual seton being in. :S
 

Jennifer

Adminstrator
Staff member
Location
SLO
I can't help with the fistula part, I was just commenting on the open wound you said was there and gave a suggestion on how to help it heal instead of having it burned over and over. :p Obviously if you need that hole open though for the fistulas to heal then you can't do it until they do.

My mom didn't use any metal to pack it. The kit we were given came with these long wooden Q-tip swabs and she used them to push the packing down. Had to pull the packing out in the shower and scrub it clean and then have it repacked right after the shower. The packing is soaked in a saline solution before you put it in so its not all dry and super painful going in and the shower helps to re-moisten it for easier removal. We did this twice a day for a month so it healed from the inside out. Yes it did heal and it did hurt but you can easily tough it out. The pain is more odd than painful if that makes any sense. :p
 
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