Fistula on the surgical suture treatment. Fistula treatment with folk remedies - Healthy lifestyle recipes

It often happens that an infection that progresses inside is looking for a way out. This is especially true after surgery. Consider why this happens and how a fistula that appears after surgery is treated.

Fistula - what is it?

A fistula is a channel that connects body cavities or hollow organs to each other or to external environment. It is lined with epithelium, and pus comes out through it, or the channel is lined granulation tissue. If this does not happen, then a purulent fistula is formed.

Such a process may be the result of any inflammatory process in the body or as a consequence of surgery.

Types of fistulas

Depending on where the fistula is located, they are divided into:

• Gastric fistula.
• Rectal.
• Rectovaginal fistula.
• Duodenal.
• Bronchial.

The fistula may be complete or incomplete. The full one has two holes and is treated faster, as it has a way out, while the incomplete one, having one hole, further develops the inflammatory process, the number of bacteria increases.

The fistula can be labial or tubular. The labioform is treated only with the help of surgery.

If we consider the process of formation, then the granulating fistula is one that is not yet fully formed, and the tubular fistula is already lined with epithelium and is fully formed.

What are the causes of a fistula after surgery?

There are several reasons for this phenomenon:

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 reaction of the body to a foreign body.

The fistula at the suture after the operation forms a seal of the suture itself, fibrous tissue and collagen fibers.

How to recognize the appearance of a fistula after surgery?

Since this is primarily an inflammatory process, then recognize the fistula after surgery characteristic symptoms not difficult. They are:

If you have these symptoms, you need to urgently see a doctor, otherwise the infectious process may spread to the organs or cause blood poisoning.

Fistula Diagnosis

It is not difficult to diagnose a fistula after surgery, since it can be seen visually if it is external. The doctor, after listening to the patient, examining, pays attention primarily to:

• Quantity and quality of secretions.
• On 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 fistulous 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 will show the presence of hydrochloric acid, and urinary - the presence of uric acid salts.

It happens that the seam may begin to fester after a long time after the operation, so you need to find out the reason for this phenomenon.

If a fistula still appears after surgery, how to treat it?

Fistula treatment

For successful therapy, first of all, it is necessary:

As a rule, the wound begins to heal. If this does not happen, then it is possible surgical intervention, in which excess granulations are removed, and cauterization of areas is possible.

The latest method is the treatment of a fistula after surgery using ultrasound. This method is considered the most gentle, but it is not the fastest.

In severe cases, if several fistulas have formed, excision of the postoperative scar is shown completely. The infected suture 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 a few weeks. The wound will heal faster if you provide it with complete rest and proper care.

After rectal fistula surgery, the doctor usually prescribes a diet so that the wound heals faster. After such operations, it is necessary to prescribe painkillers and antibiotics. The wound heals within a month, any physical exercise.

The treatment prognosis is generally good and the patient makes a full recovery.

Folk methods of treatment

Of course, people are always trying to cure the disease at home. There are several recipes for the treatment of fistulas. folk remedies. Here are some of them.

It is worth noting that if a fistula has formed after the operation, then the treatment should take place under the supervision of doctors, and folk remedies are an addition to the main course.

Fistula Prevention

In order to prevent fistulas from appearing after surgery, it is necessary:

• First of all, observe the rules of asepsis during the operation.
• All instruments and suture material must be sterile.
• It is necessary to carry out the treatment of the wound before sewing it up.
• Alloying of vessels should occur with a small capture of tissues.
• Prescribe antibiotics to prevent infections.
• Everything needs to be treated infectious diseases preventing the development of fistulas.

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Postoperative is pretty frequent complication, which can be formed by different reasons. As a rule, a fistula is formed after surgery on tubular organs or during abdominal operations. This purulent channel may not heal for a long time and lead to damage to the body in different places and sometimes even education malignant tumors. It is evidence that a serious inflammatory process is taking place in the body.

A fistula on the leg after surgery usually develops due to eventration, suppuration of surgical scars, if the suture material becomes contaminated and infected with pathogenic microorganisms. A seal (granuloma) is formed around the fistula, which consists of a ligature thread and cells with fibrous tissue, macrophages, collagen fibers, etc.

Most often, fistulas are formed due to the use of silk threads.

Any operation can be the reason: with a leg fracture, muscle injury, etc.

The fistula may not form immediately, but several months or even several years after the operation. Usually develops in conditions of reduced immunity.

Symptoms

With the development of a fistula, the symptoms are very pronounced and pronounced. The most obvious signs include:

• seals and hot tubercles (granulations) form around the infected suture;
• the scar becomes very inflamed;
• pus is released from the wound in small or large quantities;
• this place is much redder than the surrounding tissues;
• edema forms in this place;
• pain in the affected area of ​​the leg;
• body temperature rises to 39 0 C.

Why are fistulas dangerous?

If suppuration does not go away for a long time and reaches a large size, an abscess may begin. In this case, general intoxication of the body may occur, which can lead to any consequences up to disability.

Also, do not start the process so that it does not become chronic.

The constant discharge of pus can lead to the development of dermatitis.

Treatment

Treatment of a fistula on the leg after surgery may not be required if the ligature thread comes out on its own. But you should not hope for this, and with the formation of a fistula, you should immediately seek help from a doctor.

Most often, the treatment consists in removing the festering ligature thread, after which a course of anti-inflammatory therapy and antibiotics is carried out. You also need to take vitamins and drugs to increase immunity. In order for the wound to heal faster, it is washed with a solution of furacilin or hydrogen peroxide to ensure disinfection.

In addition to removal, cauterization of the wound is carried out and all purulent granulations are carefully scraped out.

Treatment of fistulas with ultrasound is also practiced. This is a more modern and gentle method.

With the formation of several fistulas, the wound is opened, washed and new stitches are applied.

Prevention

Prevention should be done by the surgeon during the operation. He is obliged to comply with all security measures to ensure sterile conditions for the operation. The suture material must be clean and sterile, and the wound must be washed.

New modern self-absorbable threads, such as Dexon or Vicryl, are also good in this regard.

Any surgical intervention serious challenge for the human, requiring strength and time for full recovery. That is why it is very important that there are no complications after the operation. Unfortunately, fistulas often occur in operated patients. What is it and how to deal with them?

Description

A fistula (also known as a "fistula") is fairly easy to recognize: it's actually a hole in the skin followed by a narrow channel.

A fistula may appear as a result of any pathological process in the body, but most often it occurs after surgery. Fistula is a common complication after surgery (up to 5% of cases), it can occur both a few days after surgery and after several months.

• The principle of cleanliness and sterility during surgery.
• Before the operation, a mandatory check of the processing of instruments, the suture material used (packaging integrity, expiration date).
• Thorough washing of the wound before suturing.
• Use of high-quality self-absorbable suture materials.
• After the operation, the surgeon and other medical staff should also take all measures aimed at preventing postoperative complications, including the appearance of fistulas: regular examination of the patient, dressing, processing and sanitation of the suture.
• In addition, the doctor should always inform the patient about possible postoperative complications, their symptoms, necessity and importance timely treatment for help.

The implementation of measures to prevent complications after surgical interventions, including fistulas, significantly reduces the risk of their occurrence.

While watching the video, you will learn about what a fistula is.

Fistula is an unpleasant complication after the operation. Its appearance requires immediate medical attention. The fistula speaks of an inflammatory process in the body, suppuration of the suture material. Treatment of postoperative fistula is to remove the purulent area and affected tissues.

overlay surgical sutures – last stage performing an intravenous operation. The only exceptions are operations on festering wounds where it is necessary to ensure the outflow of contents and reduce inflammation on the surrounding tissues.

Sutures are natural and synthetic, absorbable and non-absorbable. A pronounced inflammatory process at the suture site can lead to the release of pus from the incision.

The outflow of serous fluid, thickening and swelling of tissues indicates such a pathological phenomenon as a ligature fistula of a postoperative scar.

Why does a ligature fistula appear after the operation

A ligature is a thread for tying blood vessels. By applying a suture, doctors try to stop bleeding and prevent its occurrence in the future. Ligature fistula is an inflammatory process at the site of wound stitching.

It develops due to the use of material contaminated with pathogens. The pathological element is surrounded by a granuloma - a seal that consists of different tissues and cells:

The ligature thread is also part of the granuloma. Its suppuration is dangerous for the development of an abscess.

It is clear that the main reason for the formation ligature fistula lies in the infection of the suture material. The development of an unfavorable process is provoked by various factors:

• Avitaminosis.
• Syphilis.
• Tuberculosis.
• General condition and age of the patient.
• Hospital infection (streptococcus, staphylococcus aureus).
• Oncological diseases involving protein depletion.
• High immune reactivity of a young organism.
• Rejection of the thread by the body due to individual intolerance to the material.
• Wound infection due to lack of antiseptic treatment.
• Metabolic disease ( diabetes, obesity).
• Localization of the operated area (belly in women after caesarean section, paraproctitis).

Ligature fistulas occur in any part of the body and in all types of tissues. As for the time of their appearance, there are no exact forecasts here. In some patients, the problem occurs after a week or a month, but it also happens that the fistula bothers a year after the operation.

Symptoms of a ligature fistula

The following symptoms help to identify a fistula on a scar after surgery:

• In the first days after the operation, the area thickens, swells, and causes pain when palpated. The skin surrounding the wound turns red, the local temperature rises.
• A week later, when pressing on the seam, it is released serous fluid and pus.
• Body temperature rises to 37.5 - 39°C.
• The behavior of the fistula is unpredictable - the passage can spontaneously close and reopen later.

Completely getting rid of the channel helps only reoperation. What a ligature fistula looks like can be seen in the photo.

Outwardly it deep wound with inflamed skin around the edges. Interestingly, the fistula can form completely different from where the incision was made. Physicians are aware of cases when inflammation developed for a long time inside the patient's body, but the person himself understood that he was sick only when a small hole appeared on the body, from which purulent-serous fluid oozed.

A fistula is a hollow channel inside the body, a kind of link between organs and the external environment. It can also be an articulation internal cavity and oncological neoplasm. The channel, which looks like a tube, is lined with epithelium from the inside. Pus comes out through it. In advanced cases, bile, urine, feces come out of the fistula.

Postoperative fistulas are divided into several types:

• Full. Features two outlets. This structure contributes rapid healing.
• Incomplete. The fistula has one exit inside abdominal cavity. In such conditions, the pathogenic flora multiplies rapidly and enhances the inflammatory process.
• Tubular. A properly designed canal releases purulent, mucous and fecal masses.
• labial. The fistula fuses with muscle and dermal tissue. It can only be removed by surgery.
• Granulating. The fistula is overgrown with granulation tissue, the surface of the surrounding skin looks hyperemic and edematous.

In the ICD-10, the ligature fistula is listed under the code L98.8.0.

Most often, ligature fistulas are formed at the places where the silk thread is applied. To avoid this problem modern doctors use a material that does not require the removal of sutures and through a short time dissolves on its own.

Diagnosis and treatment of ligature fistula on the scar

Ligature fistula is diagnosed during the examination postoperative wound. For a complete study of the suspicious area, the patient is sent for ultrasound and fistulography. This is a kind of X-ray using contrast agent. The picture clearly shows the location of the fistulous canal.

Treatment of a ligature fistula involves A complex approach. Patients are prescribed different groups funds:

• Enzymes chymotrypsin and trypsin.
• Antiseptics for local treatment.
• Antibiotics SSD - Norfloxacin, Ampicillin, Ceftriaxone, Levofloxacin.
• Water-soluble ointments - Levomekol, Levosin, Trimistin.
• Fine powders - Baneocin, Gentaxan, Tyrozur.

Enzymes and antiseptics are injected into the fistulous canal and surrounding tissues. Substances act within 3 - 4 hours, therefore problem area processed several times a day. With abundant expiration of purulent masses, it is forbidden to use Vishnevsky's liniment and synthomycin ointment. They clog the channel and delay the outflow of pus.

In order to relieve inflammation, the patient is sent to physiotherapy. Wound quartzing and UHF therapy improve blood and lymph microcirculation, reduce swelling and neutralize pathogenic flora. The procedures provide a stable remission, but do not contribute to a complete recovery.

Complications of a ligature fistula: abscess, phlegmon, sepsis, toxic-resorptive fever and eventration - prolapse of organs due to purulent fusion of tissues.

Non-closing ligature fistula is treated by surgical treatment complicated postoperative wound. The site is disinfected, anesthetized and dissected for complete removal suture material. The cause of the fistula is also excised along with adjacent tissues.

To stop the bleeding, an electrocoagulator or hydrogen peroxide (3%) is used, otherwise the flashing of the vessel will provoke the formation of a new fistula. The surgeon's work is completed by washing the wound with an antiseptic (Chlorhexidine, Decasan or 70% alcohol), applying secondary seam and organization of drainage in the treated area.

AT postoperative period the drainage is washed and the dressing is changed. With multiple purulent leaks, antibiotics are used, Diclofenac, Nimesil and ointments - methyluracil or Troxevasin. Minimally invasive methods of fistula removal, for example, through ultrasound, are ineffective.

Any surgical intervention is associated with the risk of complications. Surgical childbirth is no exception. Common complications include the appearance of a ligature fistula after a caesarean section. Fistulas are dangerous because they are a source of infection. If you do not pay attention to the pathological phenomenon in time, then intoxication of the body may occur. What to do if a fistula appears? Apply for qualified help, only in this way it is possible to avoid the risks associated with the inflammatory process.

To avoid complications after the surgical birth process, all recommendations of doctors should be followed.

Cesarean, like any other surgical intervention, ends postoperative care cut places. Final stage surgical delivery- suture. For this, a ligature is used - a surgical thread. It helps stop bleeding. The thread prevents subsequent blood loss. The surgical material should not cause worries to the patient. However, during childbirth of an operational nature, it is highly likely that the threads will rot, as a result of which an abscess forms in the tissues.
An incision in the abdominal cavity, which is mandatory for cesarean delivery, is always treated before suturing. If bacteria enter the wound or pathogenic microorganisms are on the thread, then suppuration occurs. This ultimately leads to complications.

The thread that tightens the edges of the incision "overgrows" with a granuloma - tissue compaction. Suture material, fibroblasts, collagen fibers can get into the seal. Under the influence of microbes, suppuration of the seam occurs. After a breakthrough, purulent discharge oozes. A part of the surgical thread can also come out with it. The place where suppuration is opened begins to “whistle”, because a through hole appears - a fistula. Usually suppuration breaks in one place, but there are breaks in several areas. It all depends on the cause and characteristics of the inflammatory process.

A complication may appear a couple of days after surgery, that is, when the patient is still in the hospital. A fistula may appear after discharge. Sometimes the inflammation fades, the breakthrough closes, but after a while everything repeats. This happens when proper therapeutic measures and the factors of suppuration are not eliminated.

Causes of complications

The formation of a fistula after cesarean is due to a number of reasons. Complications occur when:

• initial infection of the suture;
• infection of the surgical material with the contents of the wound;
• using low-quality thread;
• violation hygiene procedures during caesarean and after it;
• insufficient seam processing.

The risks of developing an inflammatory process increase if the immune system is weakened. Functions in parturient women immune system reduced, due to the process of gestation, birth stress. Sometimes this leads to cellular rejection foreign body(thread) or provokes the appearance allergic reaction for surgical material.

What is dangerous fistula

Timely diagnosis of pathology is the key to a quick recovery

Fistula - dangerous phenomenon requiring immediate action. With large purulent accumulations, the likelihood of secondary infection is high. When purulent discharge intense, skin irritation occurs. This leads to dermatitis. If a pathological process ignore and allow its development, then severe intoxication of the body can occur - with a breakthrough, there is a high probability that bacteria that cause inflammation enter the bloodstream. Because of this, the patient may become disabled. Lethal outcomes are also recorded.

Fistulas are dangerous and their complications. Availability purulent focus can provoke severe reaction organism, expressed extremely high temperature. An exacerbated temperature reaction is called toxic-resorptive fever. It leaves an imprint on all organs and systems. Phlegmon is also referred to fistulous complications. This is the name of the process of spreading purulent deposits subcutaneously. Pus flows into adipose tissue. If purulent discharge melts the wound after a cesarean, then organ prolapse may occur.

Risks can be reduced only by timely detection of a fistula. After the diagnosis of the pathological process, it is necessary to carry out treatment, including measures to prevent complications.

Symptoms of a pathological phenomenon

Ligature fistulas can be identified by a number of symptoms. It is not difficult to identify pathology, because it is accompanied clear signs. Notice the fistula at the incision site from caesarean woman can at home. This is important, because the complication does not always appear immediately after surgery, sometimes it occurs after a couple of months.
What are the signs of complication? You need to pay attention to:

• seals around the wound;
• hot to the touch area of ​​the wound channel;
• redness near the scar (more often goes in the course of suturing);
• swelling of the tissues around the wound;
• pus (sometimes purulent contents are separated into minimum quantity: the sutured wound gets a little wet).

Almost always, the formation of fistulous openings is accompanied by a significant increase in temperature. On the early stages temperature deviations from the norm can be minimal, but do not ignore them.

Diagnostics

It is difficult not to notice the fistula. You can only miss the beginning of the formation of the inflammatory process. As it develops, it becomes obvious. However, if the patient undergoes regular examinations after a caesarean section, the doctor will notice infection of the sutured wound. Diagnostics includes:

The fistula may appear as late complication KS. A woman after a surgical delivery should regularly examine the wound. Noticing alarming manifestations (even if so far they are insignificant), you should immediately consult a doctor. A qualified diagnosis will allow you to identify a complication even before it begins to develop. This will make it possible to quickly take measures aimed at eliminating risks to the health and life of the patient.

Treatment Methods

If complications occur after a cesarean section in the form of a ligature fistula, you should consult a doctor. Only a specialist can prescribe a treatment that will bring results. Self-medication is strictly prohibited. This leads to irreversible consequences. Opening suppuration and cleaning the fistula at home are fraught with an increase in the inflammatory process. There is also no need to wait for the spontaneous exit of the thread. Waiting can lead to the spread of infection to nearby tissues and even to the entire body. Severe cases often end in disability or death.

Conservative therapy

If a fistula occurs after CS, the doctor determines the exact location of the infected area, finds the cause of the inflammation, assesses the degree of development of the pathology and possible risks. Only after that the doctor determines the method of treatment.
If the case is not neglected, it is possible to turn to conservative therapy. This method consists in removing the infection using various antibacterial solutions, antiseptics.

The site of inflammation is treated daily with special medicines that kill bacteria. Frequent washing of the wound is necessary to remove pus and disinfect the suture site itself. This promotes rapid healing of the incision site. When the infection can be stopped, the fistula closes on its own. If the infection has spread, the doctor may prescribe a course of antibiotics. Additionally, the patient is discharged vitamin complexes, the action of which is aimed at increasing immunity. When protective functions body return to normal, the process of dealing with complications after CS accelerates naturally.

A conservative method of treatment is not always possible. After such therapy, the likelihood of relapse remains, because the surgical thread remains intact. If the causes of complications were directly related to the thread, and the doctor could not determine this, then the development of fistulas may recur.

Operational Methods

In some cases, immediate medical attention is required

Treatment of fistulas most often involves surgery. Especially if the pathological process was not fixed immediately. The operational method has two options:

• thread removal;
• fistula excision.

Extraction of the surgical thread is carried out through a small incision. First, the surgeon releases pus, cleans the cavity, thoroughly rinses the wound. The thread is removed blindly. This does not always work out the first time, so exacerbations are possible, during which the thread is again removed. If the surgical material can be obtained the first time, then the fistula is permanently tightened.
Why not make a wide incision? This would provide a 100% result, because the ligature thread, which led to inflammation, could be seen. The use of such an incision is dangerous by infecting "healthy" threads, and the risk of developing phlegmon increases.
After evaluating the fistulous canal, the doctor may decide not to make an incision at all, but to use it to extract thin tool, for example, a special clamp. It is inserted into the fistula. The instrument penetrates the canal and removes the surgical material. After removing the thread that caused the complication, the wound is treated with antiseptics, dressings are made.

There is another way to remove the thread - under the control of ultrasound. Plus this method- the doctor knows exactly where the material is localized. However, this method is not practiced in all clinics, because the procedure requires modern equipment.

Removing the thread is considered sparing operational method, but there is also a radical one - excision of the fistula. The advantage of this procedure is efficiency. First, the doctor treats the operating site, conducts local anesthesia, and then makes a single block excision. The fistula is removed, and with it the ligature thread. The final stage procedures - treatment of the place of removal and suturing. The state of the wound is controlled for the next five days, it is treated. The procedure involves the removal of sutures when the excision site is delayed.

Preventive measures

It is impossible to completely exclude the possibility of fistulas after surgical delivery. Complications can arise even if the most aseptic conditions were observed during the operation. Microorganisms can penetrate even when it would seem impossible. Nobody can predict the reaction of rejection at all.
However, there are a number of preventive measures that need to be taken to prevent complications after a cesarean. These include:

• compliance with the rules of asepsis / antisepsis;
• careful preparation of the wound;
• the use of modern surgical materials and their thorough verification.

Will the preventive measures- depends on the doctor, so you need to choose the right specialist who will perform the caesarean section. It is important to assess the conditions of the hospital where the operation will take place. There is no absolute insurance against the appearance of a fistula, however, timely detection and subsequent treatment makes it possible to give a favorable prognosis.