Fistulotomy
Fistulotomy
A fistulotomy is a surgical procedure that involves the opening of a fistula to promote healing. Fistulas are abnormal connections between two body parts, such as an organ and the skin, or between two blood vessels. They can occur anywhere in the body but are most commonly found in the anus and the skin.
Indications
Fistulotomy is primarily indicated for the treatment of anal fistulas. These are often caused by an abscess in the anal gland that spreads to the skin. Patients with anal fistulas often experience pain, swelling, infection, and drainage of pus or blood. Fistulotomy can also be used to treat fistulas in other parts of the body, depending on the location and severity of the condition.
Procedure
During a fistulotomy, the surgeon cuts open the entire length of the fistula, from its internal opening to its external opening. The wound is then left open to heal from the inside out, a process known as secondary intention. This allows the fistula tract to heal without the risk of it re-forming. The procedure is usually performed under general anesthesia or spinal anesthesia.
Risks and Complications
As with any surgical procedure, fistulotomy carries some risks. These may include bleeding, infection, and damage to surrounding tissues. There is also a risk of incontinence if the fistula is close to the anal sphincter. However, the risk is low and is often outweighed by the benefits of the procedure.
Postoperative Care
After a fistulotomy, patients are usually advised to take pain medication and to soak in a warm bath several times a day to help with healing and pain relief. They may also need to change their dressings regularly and to take antibiotics to prevent infection. Follow-up appointments with the surgeon are also necessary to monitor the healing process.
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Contributors: Prab R. Tumpati, MD