The perianal skin requires some special attention after surgery as it is a highly innervated area (it’s got a lot of nerve endings) and you have to keep using it!

In addition, it is clearly impossible to keep the area sterile. The body is good at healing this area of skin in spite of the above constraints however the advice below may prove useful:

Care of the wound

The aim is to keep the surgical wound socially clean, it can never be sterile. After a bowel motion, use babies “Wet Wipes” to clean up and dab the skin dry with toilet tissue, don’t rub!. Place a dry absorptive gauze dressing or panti-liner inside your undies to keep clean.

How long will it take to heal?

Infection is uncommon in perianal wounds however healing is relatively slow. Frequently wounds will be left open to heal without stitches, as stitching a wound will lead to infection. Wounds, while open, will weep a small volume of serous or slightly blood stained fluid until healing is complete. This may take up to four weeks. Itching in the healing wound is common but resist the temptation to scratch, although it gives temporary relief it makes it worse shortly after!

Pain and how to minimise it

Take medication regularly (usually 1gm of paracetamol 6 hourly and an anti-inflammatory or Tramadol). Sit in a warm bath or hop in the shower after a bowel motion or if the pain is not relieved by the medication you have been given. Some local anesthetic (lignocaine gel) is useful for temporary relief and is applied to the wound under a gauze square.

Keep your bowels working!

Make sure you don’t get constipated after surgery. Natural laxatives include kiwi fruit or processed variants (Kiwi crush or Necta) and magnesium salts 150 to 400mgs daily. If needed take some extra fibre as Konsyl-D or Metamucil, or a gentle laxative such as Lactulose.

More information needed?

“Informed consent for surgery is a process not a piece of paper”! The expected outcome of surgery (return to health) must be weighed against the small chance of an adverse outcome or complication. If you require more information on any aspect of your condition or proposed treatment please make an appointment to discuss your concerns.

Useful websites

www.cssanz.org

www.fascrs.org

www.acpgbi.org.uk