Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Post Abscess Incision and Drainage operation



12-07-2017, 01:30 PM   #1
Wakes
 
Join Date: Dec 2017
Location: South Africa
Post Abscess Incision and Drainage operation

So this was my first surgery ever, had a huge abscess on my lower right buttocks and decided to do the incision and drainage operation, now I'm left with an open wound about 7cm in length and 1cm deep and 4cm width. Please help with what is the norm if any after operation, 5 days post op and still no bowl movement, antibiotics was only 5 days as well, and still can't sit down. Anyone have a general idea what is the healing process?
12-08-2017, 12:17 PM   #2
AreWeThereYet
 
Join Date: Nov 2017
Location: Seattle, Washington
I've had dozens of I&Ds, and the surgery you describe is an I&D plus deroofing...a more open and extensive surgery than a simple I&D. So if reports on the internet aren't matching your experience, that's why. Now, on to your questions.

5 days post op, you should have had a bowel movement. Frankly, you should have had a BM within 48 hours of surgery. You need to report it to your doctor and start taking a laxative IMMEDIATELY. 5 days of bowel inaction is dangerous for the health of your bowel, plus if you do manage to have a BM after that long it will be very hard and painful. If you are taking narcotic pain killers, this is very like why you are constipated. I regularly use metamucil twice daily post op to ensure regular, comfortable BMs. Since you are already constipated, treat with laxatives and then set up a fiber maintanence regimine.

A 5 day course of antibiotics is normal, and should be effective. If you have a fever over 100, can feel any hard places around the wound, or observe any skin breakdown around the wound, it could indicate infection or formation of a new abscess. Call your doctor.

What is the general healing process? I find it takes a solid 2 weeks after a procedure with a resulting wound like yours to begin to regain some normalcy. My docs always say things like "Everyone is different, but 3-5 days and you should see significant improvement." HA! Not even close. 2 weeks til you can sit with a donut and shower/bathe without acute pain. 2 more weeks for the wound to heal near entirely. If your surgeon hasn't given you pain meds, insist he does. This recovery is neither short nor easy.

A final note: If you are 5 days post op and still in significant pain, that's normal...to a degree. If you are in too much pain to sleep, or if you spend most of your days howling in agony, return to your surgeon for an exam, and request a full blood panel and a CT with contrast to look for proliferating infection.

Hang in there. It'll get better. And post any more questions you have here...I've got nothing but time on my hands and lots of experience with this.
12-08-2017, 02:18 PM   #3
Wakes
 
Join Date: Dec 2017
Location: South Africa
Thanks so much. Your insight really helped .
12-08-2017, 02:22 PM   #4
Wakes
 
Join Date: Dec 2017
Location: South Africa
Yeah I'm on some heavy pain medication so that should definitely be the cause of no BM. Don't really mind cause the wound is extremely close to the anus.An having no discomfort from not using the toilet.
12-08-2017, 06:19 PM   #5
AreWeThereYet
 
Join Date: Nov 2017
Location: Seattle, Washington
Yeah I'm on some heavy pain medication so that should definitely be the cause of no BM. Don't really mind cause the wound is extremely close to the anus.An having no discomfort from not using the toilet.
I totally get that, but its gotta happen sometime When it IS time for your fitst BM, I highly recommend using a gauze 4x4 to cover the wound, and applying gentle firm pressure to the wound with your whole hand. It'll help keep the wound clean, and help relieve the pain of your rectal muscles contracting and bearing down.
12-09-2017, 12:24 AM   #6
Wakes
 
Join Date: Dec 2017
Location: South Africa
Just my luck woke up this morning to have my very first painful BM. Body is shaking a lot but think that is just from the adrenaline rush. As I type this in a sitz bath while I wait for the gauze you recommend to come. What wound cream works the in terms of speeding up recovery?, I'm currently on medalium. It's a Aloe and honey based cream with some vitamins as well. Having this wound so close to the rectum is extremely worring cause as soon as I sat an used some pressure to push the bandages started coming off and really don't want to get an infection. So need this to heal up fast. Any tips on helping the recovery on, read that I must walk more and more every day to help get the blood flowing, so been doing that even if I walk like a penguin now. Been laying on my side to help push the wound closer together. My diet is high protein right now.
12-09-2017, 12:33 AM   #7
Wakes
 
Join Date: Dec 2017
Location: South Africa
How often do you also change the dressing?. I'm currently on once a day.
12-09-2017, 12:37 AM   #8
AreWeThereYet
 
Join Date: Nov 2017
Location: Seattle, Washington
I changed the dressing with each sitz bath, 3x daily.
12-09-2017, 12:40 AM   #9
AreWeThereYet
 
Join Date: Nov 2017
Location: Seattle, Washington
Eat less protein and more fiber, specifically herbs and dark leafy greens. They're high in vitamin k, which will promote healing. My doc never recommended any ointment though, so I'm no help there. I know honey is an excellent antibacterial though, so your salve sounds great.
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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Post Abscess Incision and Drainage operation
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