Can I wash with saline after anal fistula surgery?

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

Saline cleaning is acceptable after anal fistula surgery, but should be adjusted according to the postoperative stage. Once the surgical wound has stabilized, warm saline sitz baths are recommended for cleaning. However, during the early postoperative period, if there is active bleeding or sutures have not yet been removed, self-cleaning with saline is not advisable and wound care should follow medical instructions. Daily care requires keeping the wound clean and dry. In addition to proper cleaning, patients should consume more dietary fiber-rich foods.

Saline cleaning after anal fistula surgery is possible, but should be adjusted according to the postoperative stage. Warm saline sitz baths are recommended once the surgical wound has stabilized; however, during the early postoperative period—especially if there is active bleeding or sutures have not yet been removed—self-cleaning with saline is not advisable and wound care should follow medical instructions. Detailed explanations are as follows:

Starting from the third day after surgery, if there is no obvious bleeding at the wound site, using a 0.9% concentration of medical-grade normal saline or mild saltwater for sitz baths can help clean wound secretions, reduce bacterial growth, relieve spasm of the anal sphincter muscle, and alleviate pain. Each session should last 10–15 minutes, performed 2–3 times daily. After washing, gently pat the area dry with sterile gauze.

On the day of surgery or when the wound is oozing blood or sutures remain in place, saline may irritate damaged blood vessels and worsen bleeding, or interfere with clot formation. At this stage, use only antiseptic solutions prescribed by your doctor, along with sterile dressings changed regularly, and avoid self-cleaning with saline. Additionally, excessively concentrated saline solutions may irritate the wound, cause pain, and impair healing.

In daily care, it is important to keep the wound clean and dry. In addition to proper cleaning, maintain a diet rich in dietary fiber to ensure smooth bowel movements and prevent constipation or hard stools that could rub against and damage the healing wound.

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Is it normal for the wound to itch after surgery for anal fistula?

In general, it is normal for the wound to itch after surgery for anal fistula. After the surgery, as the wound gradually heals, a series of normal physiological changes occur, including itching at the wound site. This is primarily due to the continuous growth of new granulation tissue and the gradual repair and development of nerve endings, which may cause a sensation of itching.

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How to clean the wound after anal fistula surgery

Under normal circumstances, methods for cleaning wounds after anal fistula surgery include warm water sitz baths, disinfection with iodophor, potassium permanganate solution cleansing, sulfur soap cleansing, and using sterile normal saline. Patients who have undergone anal fistula surgery should also check the wound daily for signs of infection such as redness, swelling, discharge, or unusual odor. If any abnormalities occur, immediate medical attention is required.

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Is it necessary to change the gauze in the wound every day after surgery for an anal fistula?

The gauze packed in the wound after fistula surgery needs to be changed daily. The primary purposes of packing the wound with gauze after fistula surgery are to apply pressure to stop bleeding, drain secretions, and prevent false healing. There will be exudate from the wound after surgery, including blood and tissue fluid. If the gauze is not changed in a timely manner, accumulation of exudate may lead to local infection, impair wound healing, and even potentially cause the formation of a new anal fistula.

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How long after anal fistula surgery should there be no bleeding?

There is no fixed standard for the time of cessation of bleeding after anal fistula surgery. Generally, bleeding significantly decreases and gradually stops within 3 to 7 days postoperatively. The exact duration depends directly on the size of the surgical wound, individual coagulation function, and postoperative care. Patients with smaller wounds and proper care tend to recover faster, while those with larger wounds or inadequate care may experience prolonged bleeding. In terms of diet, it is recommended to consume more liquid foods such as porridge and well-cooked noodles.