Seton surgery for abcess and fistulae still not healed, how long should it take?

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bwrmom
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Date Joined Jun 2008
Total Posts : 7
   Posted 9/18/2008 9:58 PM (GMT -7)   
cry  My husband had and perianal abcess almost eight weeks ago. He has crohn's disease and is on penisone and 6mp. They inserted a seton stitch and have me packing the wound twice daily, he is not so happy. The wound is still not healed shut and when we ask the surgeon how long this should take he just says it closes when it closes. He does admit that it has taken a little longer  because of the meds. He also said he usually does a second surgery to fix the fistulae once the abcess is healed. Has anyone had experiience with this?

Betagirl
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Date Joined Jan 2003
Total Posts : 1928
   Posted 9/19/2008 5:36 AM (GMT -7)   
I had a fistulotomy (where they just cut the dang thing open). It took a good 6-8 weeks to close. It's kind of barbaric since they just slice it open and say to just let the body close it on its own. Depending on the size of the fistula it could take a while. As long as it stays clean and uninfected. Though I know it's a PITA, both literally and figuratively.
"Only the meek get pinched...the bold survive."


chroniemomx2
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Date Joined Apr 2005
Total Posts : 2346
   Posted 9/19/2008 6:46 AM (GMT -7)   
With the seton in it, it won't heal closed....is the abscess wound a different place then the seton? Usually you have an abscess in the fistula tract, so when they drain the abscess, it is in the same spot as the fistula, and so you wouldn't have 2 wounds. 2 yrs. ago, I had an abscess drained and a seton put in....I still have the seton. Or, when you just have an abscess drained, there is a 50% chance that it will fistulize. When I have just had abscesses drained, it has taken longer than 8 weeks for them to totally close. Since he is on pred....that really slows healing time down.

KEANO
Regular Member


Date Joined Sep 2008
Total Posts : 76
   Posted 9/19/2008 7:18 AM (GMT -7)   
I had re-curring peranal abcesses and eventually the only thing that got rid of them was Remicade. Im now on Remicade infusions for the past 3 years with no side affects and the abcess and fistula has stayed away.

bwrmom
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Date Joined Jun 2008
Total Posts : 7
   Posted 9/19/2008 9:18 AM (GMT -7)   
Thank you. You are right he had just an abscess and the dr. said it may become a fistula. they took him off the pred. so we hoping it will help. Did you have to pack the wound no one seems to mention that part?

mj8dokken
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Date Joined Dec 2006
Total Posts : 146
   Posted 9/19/2008 9:27 AM (GMT -7)   
I had an abscess drained in May. They didn't pack mine (I am assuming it depends on the size?) and it is still open. They told me it takes as long as it takes.
Bad flare May '06 resulted in CD diagnosis-symptoms for 10 yrs prior.
Asacol: 2400 mg/day
6mp: 100mg/day
Prednisone: 10 mg/day
Entocort: 9mg/day


KEANO
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Date Joined Sep 2008
Total Posts : 76
   Posted 9/19/2008 9:31 AM (GMT -7)   
My wound was never packed but then I live in Ireland so maybe different procedure. They just put something like a piece of pipe in there and cut a piece of it each day. But to be honest it just kept draining and filling up and thats when I think the fistula came about.

bwrmom
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Date Joined Jun 2008
Total Posts : 7
   Posted 9/19/2008 12:13 PM (GMT -7)   
Thanks again. there's a lot of cruddy ailments out there it's nice to hear others have been through the same things

Betagirl
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Date Joined Jan 2003
Total Posts : 1928
   Posted 9/19/2008 5:19 PM (GMT -7)   
Yes, I had to pack my wound for a few weeks. Then my surgeon told me to just leave it open to the air to heal quicker.
"Only the meek get pinched...the bold survive."


chroniemomx2
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Date Joined Apr 2005
Total Posts : 2346
   Posted 9/19/2008 6:50 PM (GMT -7)   
Is he soaking in the tub in the hottest water possible as often as he can? That is really good for the healing process.

bad bum bob
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Date Joined Jan 2009
Total Posts : 4
   Posted 1/13/2009 3:26 PM (GMT -7)   

HELP            ..fistual   seton..

Im a 33 yr old male,    I had an abcess drained march 2008, the wound was left open and packed daily for 2 weeks.everything seemed ok, then i started to leak and continued for several months, i was addmitted to hospital 5 days ago for an opp. ive had what i believe to be a seton placed where the the puss was leaking. i have been in real bad pain since especially when i need to go for a number 2..the hospital have not been much help in explaining what ive had done..  i visited my GP yesterday. who was not much help either. he drew a diagram of this seton.which looked like a braid or string with beads on. so if anybody could help explain what this is, amd more importantly what it does, and how long will this horrible pain last, i would be very thankful for your help..

                     thanks  bob


Post Edited (bad bum bob) : 1/13/2009 3:36:21 PM (GMT-7)


patientspiders
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Date Joined Jul 2005
Total Posts : 729
   Posted 1/13/2009 4:03 PM (GMT -7)   
Hey Bob... you might want to repost your question as it's own "topic"... I'm afraid you might not get as much help here at the bottom of this post!

I've had just about every kind of seton... this string that you say your GP illustrated for you... is it connected/circular like a rubberband?
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
(miscarried at 13 weeks, now waiting to heal before trying again)
Stopped Humira August 22nd, 2008.
Went Gluten-Free, noticing some definite improvement.
Started LDN October 27th, and already LOVING IT.

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."


bad bum bob
New Member


Date Joined Jan 2009
Total Posts : 4
   Posted 1/13/2009 4:39 PM (GMT -7)   

.Thanks for reply.

my seton has 2 peices of like plastic string protruding. i will try reposting,, thanks again

 

binlid
New Member


Date Joined Apr 2009
Total Posts : 3
   Posted 4/12/2009 6:53 AM (GMT -7)   

c-ton problems

hi there, just read your comment there bob, im exactly same. got c tons in jan had 2 rather big abcesss in my rear end. now we are into april they are still draining. was at hospital last wk with pain they had no answers why i am so sore they told me to take painkillers regulary. ive another op early may. i was hoping i would be pain free and it would all be over by summer but reading other peoples stories there it could be a while. anyone with advice or lenght of healing please get on touch. oh yea i go to my GPthis is all new so they cant help.

thanks


FallColors
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Date Joined May 2007
Total Posts : 1220
   Posted 4/12/2009 7:51 AM (GMT -7)   

Hello Binlid,

Welcome to the Forum!  I am so sorry you are experiencing this!  The length of healing depends on how big the abscess and incision are.  I had a large abscess in the perineum area and it took nearly 4 months to close.  Leaving the wound open to heal from the inside out really is the best procedure even though it can be a bit scary to see such a large wound.  Leaving it open will prevent nasty things from getting trapped. shakehead shakehead shakehead    I am sorry you are in pain!  Don't feel badly about taking pain meds.  Being stressed and in pain can slow healing, so take what you need to be relax and be comfortable.  These things take such time and we really need to be patient.

Unfortunately, people with Crohn's heal more slowly, and the area of the abscess doesn't help either.  Keeping it really clean and taking 3-4 sitz baths (sitting in the tub in hot water for at least 10 minutes) will help promote healing.  Make sure you are eating a lot of protein too because that promotes healing too.

The draining will continue because that is what the seton does.  Once the wound heals, the setons will still allow stuff to drain out from your rectum.  While this sounds gross, if the stuff didn't drain out it would get caught and abscess again.  nono    nono    nono    Also, make sure you don't delay in calling your doctor if something is going in the wrong direction or if you have questions.  That is what they are there for and they deal with these things daily and will help you deal with it.

I suggest you search past posts for a lot of good ideas about enduring these times.  Let us know how it goes for you!

 


Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.


binlid
New Member


Date Joined Apr 2009
Total Posts : 3
   Posted 4/12/2009 1:54 PM (GMT -7)   
thanks very much for that information, its good to no that there is bit more info out there from others anyone ive spoke to has no idea what im talking about.
 
thanks again

binlid
New Member


Date Joined Apr 2009
Total Posts : 3
   Posted 4/12/2009 2:32 PM (GMT -7)   

fallcolors or anyone out there,

 do any of you  know what actually causes these abcess' i have been reading some of posts some people it seems to be crohns is that mostly the case. i know im not the healthiest, i put it down to not eating my fruit and veg being run down, but most of time fruit and nice healthy foods that i would eat in salad for example never agree with me giving me cramps and diahorrea. so it can be hard to be healthy.

just while your there has anyone been in and out of work with pain and operations of abbcess', im due 2nd op told going to need 3rd. now work are sending for my medical records. is this just how it will be for a while?????

 


FallColors
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Date Joined May 2007
Total Posts : 1220
   Posted 4/12/2009 5:42 PM (GMT -7)   
hello Binlid,

You certainly are not alone!! Rectal abscesses are more common than we think -- its just people don't really talk about them. As my surgeon said "rectal abscesses are not dinner party conversation". Here is a good website. Make sure you check out the links on the right side too.

http://emedicine.medscape.com/article/190234-overview

Abscesses are no fault of your own. It has nothing to do with what you eat. As the article says, it starts as an infection in a gland inside the rectum and can happen to anyone. It could happen because of Crohn's disease too. Have you been diagnosed with Crohn's?

I've had 3 rounds of abscesses over a year and a half. I've missed a couple of months of work. I am doing quite well now and haven't had any problems since last May. Yea!!

The best advice I can give you is to make sure your doctor determines whether you have Crohn's or not. If you don't have Crohn's, then as soon as the abscess heals, they may be able to perform a procedure to get rid of the fistula (depending on where it starts in the rectum). If you have Crohn's, make sure your surgeon is very experienced with Crohn's. The treatments can be different for us and we take longer to heal. You will want the inflammation caused by the disease to be under control or the fistulectomy will likely fail (inflammed tissue doesn't heal well). This may mean being on a drug therapy for a while.

Once again, know that you are not alone! Ask all the questions you want here. There are many people here who have a great deal of experience -- unfortunately!

Take care!
Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 4/13/2009 8:45 AM (GMT -7)   
Or you can have a fistula and it can abscess...once my surgeon found the fistula and put a seton in it, I have not had an abscess since....it's been 2 1/2 yrs. since my last one. And before that I had around 8 of them.

pupster
New Member


Date Joined Apr 2009
Total Posts : 1
   Posted 4/28/2009 4:03 AM (GMT -7)   
Hi All,
 
Firstly, sorry to hear so many going through similiar hell.
 
I had a major perianal abcess/fistula in early March 09 that popped while I was in emergency waiting for it to be drained. I had a seton placed after the draining. I wasn't told to pack it but was ad avised to use womans pads on a daily basis while the wound drained. Was also advised to have lots of warm baths. about a week ago I ended up in emergency again as I had a constant stinging/burning pain around the anus. They think it was another infection and I was given a 5 day course of flagyl suppositories, they have helped bit but still have some pain.
 
I had a follow up with the surgen that put the seton in 4 days ago and he thinks I've done well and that the seton is ready to come out & they will make a small cut which I assume this means laying open the fistula (both pending surgery avialability in the public health system). He aslo said this next (2nd) lot of surgery will be a day procedure and that I may have some pain/bleeding for few weeks after but that should be it. (Lets hope!)
 
He also believes that smokers have a higher chance of getting this (but then again all doctors say smoking is bad).
 
I don't have crohn's although have all the symptoms and have had for about 10yrs now, so far they just say it's IBS but they're thinking of looking at this again.
 
Although sorry to hear eveyone's story it does make me feel slightly better that I'm not alone in this current hell and hope it ends for us all soon!

Post Edited (pupster) : 4/28/2009 4:08:08 AM (GMT-6)


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/28/2009 5:34 AM (GMT -7)   
I wish we had a treatment for this abscessing fistulas. I had an ano-fistula in October 2003, which was drained through incision. Later on, I had the J pouch in November 2005. The abscess formed near the anus in July 2006, both sides of my bum. They were drained from time to time. The doctor, it seems did not realise that it is going to become a fistula. Today I have this horse shoe fistula, communicating with my J pouch. All the doctors have opined that nothing can be done. They have ruled out Seton and Remicade. The pain is unbearable. It is always leaking - including the stools from that opening.

The moment I sit on any hard surface, there is a big abscess in the fistula and it takes about a week to burst open. Every day I am using about 8 to 10 dressings for the discharge from fistula for the last three years.

I am also looking for an answer to these fistulas. I must say the information by all of you is quite helpful.
45 years Male Attorney
Diagnosed UC October 1989
 
Had two stage J Pouch Surgery Nov 2005; Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
 
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle: Albert Einstein
 
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/28/2009 5:36 AM (GMT -7)   
By the way, I had partial fistuloctomy, fistulogram, pouchogram, MRI, etc. in May 2008. The biopsy report diagnosed "indeterminate colitis". So Remicade was ruled out. So was the seton, which they said may become a saton, in view of the J pouch.
45 years Male Attorney
Diagnosed UC October 1989
 
Had two stage J Pouch Surgery Nov 2005; Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
 
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle: Albert Einstein
 
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 4/28/2009 5:49 AM (GMT -7)   
Hello Pupster! Welcome to the Forum! You certainly are not alone! It is true that anyone can get an abscess and fistula. I hope your fistulectomy goes very well and you never have this problem again!

Hello PSA Delhi. Sounds like you have had a rough time of this. Have you gotten a second opinion? I wouldn't give up on a better treatment until I talked with several colo-rectal surgeons who are very experienced in Crohn's. Even if I had to travel to go to one. This is a specialty that can't be dealt with successfully by a general surgeon, in my opinion, and even some colo-rectal surgeons don't have experience with Crohn's. I hope you find a solution soon!
Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.


onthecan
Regular Member


Date Joined Mar 2009
Total Posts : 317
   Posted 4/28/2009 10:06 AM (GMT -7)   
Hi all i had a abscess to but behind it was a fistula so they put in the seton and i had mine for over 2 years it did stop draining but wouldn't heal,so they tried me on Remicade and with in the 3rd fusion they were able to take out the seton it was completely healed and i was packed for the 5 days in the hospital but after i got home i didn't have to i was told to just keep the area clean and that was a job in its self it hurt to be cleaning around that open wound but like i said it took me a long time and the only thing that worked for me was the remicade i hope that is some help for you? Jenn cry
Had Crohns 17 years had numerous bowel resections,fistulas,fissures,hemmies,kidney problems,fibro,arthritis,dignosed at 13 had GI feeding tube,nasal feeding tube,cental lines,ports,4 ruptured bowel emergency surgeries,TMJ,depression,current meds are Hydromorphone,30 ,Hydromophome,8 ,Ketoprofen,100 ,Trazadone,50 ,Lorazepam,10 ,Zopliclone,5 ,atriplyine,75 ,Losac,50 Tylenol Athritis ,B-12 injections ,Iron injections ,Gravol,75 Predisone,5mg ,Humira,40mg once a week.Still looking for the doctor with all the answers if you find him forward him to me please.P.S my bathroom is the nicest room in my house cause i spend so much time there,i am thinking about installing the computer and maybe a hot-dog stand.


Tintin
Regular Member


Date Joined May 2006
Total Posts : 33
   Posted 10/3/2009 10:21 PM (GMT -7)   
KEANO said...
My wound was never packed but then I live in Ireland so maybe different procedure. They just put something like a piece of pipe in there and cut a piece of it each day. But to be honest it just kept draining and filling up and thats when I think the fistula came about.
 
Hi!  Sorry that I am writing out of the blues.  I am a Crohnie for 18 years.  Two major surgeries and multiple hospitalizations left me an ostomate.  I will be going on Remicade in mid October due to recurring fistula problems.  Despite hearing a lot of good things about the drug, I am quite worry about the side effect but there are not a whole lot of medications left for me to try.  Since the fistulas come and go, I am wondering if I can still get the IV when there is a fistula?  Or do I have to wait till when everything quites down?  The thing is, I have to schedule the appointments ahead of time and I cannot predict when I will or will not have fistula.  Would really appreciate it if you can give me some insight. 
 
Thank you.
 
Sammy
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