What should I do about swelling after fistula surgery?

Generally, treatment methods for postoperative edema after anal fistula surgery mainly include basic nursing care, physical therapy, local medication, oral medication, and surgical intervention. Specific analysis is as follows:

1. Basic Nursing Care

The surgical wound and surrounding tissues are fragile after surgery; maintaining cleanliness and minimizing irritation are crucial. Patients should wear loose, breathable cotton underwear to avoid friction on the edematous area. After defecation, gently sit in warm water to clean the wound and reduce local irritation. After soaking, gently pat the area dry with a soft towel—avoid rubbing vigorously. The diet should be light and easy to digest, with plenty of fiber-rich foods to maintain smooth bowel movements and prevent constipation, which could worsen edema due to excessive straining.

2. Physical Therapy

Physical therapy helps improve local blood circulation and accelerate the resolution of edema. In addition to warm water sitz baths, infrared irradiation therapy can be used to apply gentle heat that relaxes perianal tissues, reduces inflammatory responses, and improves local blood supply. Local cold compresses may also be applied—within the first 48 hours after surgery, wrap an ice pack in a towel and apply it gently to the swollen area for 15 minutes at a time to help constrict blood vessels and reduce swelling.

3. Local Medication

Topical medications act directly on the edematous site to relieve discomfort. Under medical guidance, patients may use Ma Yinglong Musk Hemorrhoids Ointment to reduce swelling and pain. Alternatively, Compound Carrageenan Cream can be applied to protect the wound and soothe irritation. Diluted potassium permanganate solution may also be used for sitz baths, providing antiseptic and anti-inflammatory effects that help reduce swelling.

4. Oral Medication

Oral medications are primarily used to assist in reducing edema and preventing infection. When edema is significant, patients may take Aescuven® (horse chestnut extract tablets) under a doctor’s supervision to improve venous circulation and reduce swelling. If there is a risk of inflammation, antibiotics such as cefuroxime axetil tablets or metronidazole tablets may be prescribed to prevent infection from worsening the edema.

5. Surgical Intervention

If edema continues to worsen despite conservative treatments, or if signs of impaired local blood flow appear, timely surgical intervention is necessary. The commonly used procedure is incision and drainage of perianal edema, which involves cutting into the swollen tissue to drain accumulated fluid, rapidly relieving swelling. Postoperatively, enhanced wound care is required to prevent secondary infection.

After surgery, patients must strictly follow medical advice for regular dressing changes and attend scheduled follow-up visits to monitor wound healing. Avoid prolonged sitting or standing; engage in mild physical activity appropriately to promote blood circulation. If any abnormalities occur—such as purple discoloration of the skin at the edematous site, increased pain, or fever—contact the physician immediately for prompt and targeted management.