Coccyx fistula healing

Open and closed treatment

Depending on how the surgery of the coccyx fistula went or was done, the chances of recovery also develop.
There are roughly two different methods of treatment: the open and the closed method.
These different forms of treatment also affect the healing process.
In principle, it can be said that surgery for coccyx fistula is possible on an outpatient as well as inpatient basis, but the open procedure is usually chosen for inpatient treatment.
Regarding open treatment, it can be said that the wound usually heals well. Usually the healing process takes six to eight weeks.

However, healing can sometimes take up to six months. So it can be one lengthy course act, after all, the tissue has to grow up again from the depths and close the wound. Even so, most surgeons prefer the open treatment method, as the recurrence of a coccyx fistula is better prevented.

In the closed treatment, however, the wound is closed with sutures at the end of the operation.
Occasionally this is done before Antibiotics put in the wound so that Infections be prevented.

In the closed treatment, it is for the Wound healing It is now important to prevent sweating and wound stretching in the area. Should the course develop without complications, healing can usually be expected after 2-3 weeks.
The closed treatment usually heals much faster than the open variant.
Basically, during the operations, the fistula is completely down to the connective tissue layer over the Sacrum has been removed, there is a very good chance of recovery and a low risk of relapse.

Another factor influencing the healing and rate of regression is whether it was possible Gluteal crease to shape less deep. However, this is not guaranteed with open wound treatment.
Because with the coccyx fistula, the wound is usually in the depth of the gluteal fold. Because the buttocks lie against each other, a closed one is created moist environmentwhich that Bacterial growth favored.

Hair can also grow into the wound, which leads to irritation.
Open treatment for fistulas deep in the gluteal folds is extremely difficult. It can also cause unpleasant draws and too repeated fistulas come above and below the wound.
The area is very unstable due to its location in the gluteal fold.
Therefore, one proceeds as follows.
The fistula is incised asymmetrically, then deeply removed and sutured. The seam is done in such a way that the seam is not in the depth of the gluteal fold.

This was first made by KARYDAKIS described.
One also tries to set the seam as laterally as possible by means of a moon-shaped incision. This is called Scarpa moon flap.

A side seam can also be created by using Full thickness flap or a KARYDAKIS operation with skin subcutaneous flaps.
With these methods, the chances of recovery from fistulas in the deep gluteal fold are significantly better, but it can still be too Infections the wound and impaired wound healing.
In the KARDAKIS operation, the derivation of the Wound secretions by a Suction pump (drainage) guaranteed.

Within the first 2-3 weeks after the operation, the wound area should be strictly spared.
You can take a shower, but swimming and bathing are not allowed.
The sutures are usually self-dissolving.
Close and regular wound care should be ensured.
What is also important for proper healing is the separation of the Connective tissue deep in the gluteal fold.

In addition, the wound should be closed with antibacterial agents flushed and the threads should be treated with an antibiotic. In addition, the wound drainage through a suction bottle for about two days, a drainage should be guaranteed.

Another point in healing a coccyx fistula is therapy of the Pus and of acute abscesses.
In the case of acute abscesses, the pus must drain off as soon as possible, this can be done through a small incision local anesthesia respectively.
Treatment with an antibiotic can also improve healing.

At chronic fistulas on the other hand, the operation can be better planned than with acute ones Abscesses.
If, on the other hand, it is a circumscribed small fistula, this can be done locally with a small incision minimally invasive removed.
For this purpose, the fistula is displayed with the help of a dye. Such small defects heal by themselves in a few days. On the other hand, with this therapy the Relapse rates a new fistula higher than with a deep major operation.

Other minimally invasive procedures are BASCOM operationwhich too pit picking operation is called.
The entire hair root, inflammatory material and dead material can be removed with a small incision.

An abscess is only opened here, but it must be cleaned up after 2-4 weeks. Due to the small wound, the wound healing is much better than with complex operations, but the method can only be used with less pronounced fistula systems.
With the pit picking process, however, you could do more Accumulation of wound fluid observe (Seromas) that impair wound healing.

The formation of seromas is attempted by operating the skin and subcutaneous flaps on the superficial one Body fascia (Scarpa) to reach.
This method is gentle blood- and Lymphatic vessels and ensures better wound healing with less seroma formation.
The pit picking method is modified with Lasers. One also expects better wound healing through the fistula obliteration with the help of the laser.
Usually the pit picking operation heals after about eight weeks. In the course of healing, the wound can bleed, ooze or turn yellow Fibrin deposits show what is completely normal.

The following principle generally applies
If it is a benign disease of the fistula formation of the skin and its appendages, but without the subcutaneous fatty tissue, radical excision of the fistula is not necessary.

In general, cuts in the midline of the gluteal folds heal poorly and deeper cuts can be made outside the midline, as they heal much better.

Wound healing complications

Should the surgeon opt for an operation with sutures, the healing rate is usually 80%.
However, this closed treatment can cause the wound to expand ignited and has to be opened again.

A partial opening is recommended.
The reopening then extends the healing time again.

Another complication in the course can be a Rebleeding bleeding therapies are then to be carried out.
However, very heavy secondary bleeding occurs very rarely.

Other wound healing complications already mentioned are Wound infections or a recurring one Coccyx fistula.

Adequate follow-up treatment is also essential for healing

Aftercare

Hygienic treatment of the surgical wound is essential for good healing.
In addition, avoiding alcohol and nicotine is advisable for good wound healing.

During follow-up treatment, it is advisable to shower the wound out to ensure it heals well.
This showering should take place several times a day and especially after a bowel movement.
You should then let the wound dry for 10 minutes, insert a fresh tamponade and cover the wound again.

The positive effect of showering comes from the stimulation of the granulation of the wound fluid by showering.

Sitz baths also have a positive effect on healing.
The Sitz baths can also be used daily. There are also special medicinal baths with potassium permanganate or sea salt baths.

The effect of the baths results from their antibacterial effect. An addition with chamomile extract can also have an anti-inflammatory effect.

Wound healing ointments are another method to accelerate healing, but this is a bit controversial.
There are various betaisodona ointments that can be applied to the tamponades.

There are also wound irrigation solutions with hydrogen peroxide solutions with a concentration of 3%. The exposure time is 5 minutes after rinsing. The solutions have a good antibacterial effect and protect against infections.

There are also preventive measures that can be used before the operation to improve wound healing after the operation.

This includes the possibility of a treatment for permanent hair removal.

There are IPL or laser techniques for this.
Treatment is carried out using laser or xenon light.
This leads to a desolation of hair that is growing.

This treatment must be carried out several times before the operation to be effective. On the one hand, this pretreatment reduces the irritation of hair in the surgical wound and counteracts a possible risk of relapse and the development of new fistulas.