What causes the wound to turn white after anal fistula surgery?

Under normal circumstances, whitening of the wound after anal fistula surgery may be caused by normal granulation tissue, local moisture maceration, wound infection, ischemia, or false healing. If discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. Detailed analysis is as follows:

1. Normal Granulation Tissue

In the early stages of postoperative wound healing, newly formed granulation tissue may appear light pink or pale white, with a soft texture and no odor. Keep the wound clean and dry; perform warm water sitz baths after each bowel movement, change dressings regularly as prescribed, and avoid friction or irritation to the wound.

2. Local Moisture Maceration

Excessive wound secretions or inadequate cleaning after defecation can create a persistently moist environment, leading to epidermal maceration and whitening. Increase dressing change frequency, use sterile gauze to absorb secretions, wear loose and breathable underwear, and avoid prolonged sitting to maintain local ventilation.

3. Wound Infection

Bacterial invasion can cause wound infection, with inflammatory stimulation resulting in swollen, whitish tissue accompanied by redness, swelling, pain, discharge, and odor. Under medical guidance, perform sitz baths with potassium permanganate solution, apply mupirocin ointment topically, and take cefuroxime axetil tablets orally.

4. Wound Ischemia

Excessively tight sutures or local pressure during surgery may impair blood circulation, causing ischemic whitening of the wound, often associated with coldness and pain in the area. Seek immediate medical attention to adjust suture tension. Follow doctor’s instructions to take Huoxue Zhitong Capsules and Maizhiling tablets, and apply recombinant human epidermal growth factor gel externally.

5. False Healing (Premature Epithelialization)

The surface skin of the wound closes too early while deeper tissues remain unhealed, leading to fluid accumulation beneath the closed surface, causing the wound to appear white and feel fluctuant upon palpation. Prompt medical intervention is required for incision and drainage of the false healing site. After the procedure, irrigate the wound with normal saline and change dressings regularly to promote proper healing.

Maintain a light, easily digestible diet rich in protein. Ensure smooth bowel movements and avoid constipation or straining that could tear the wound. Follow up regularly as instructed and promptly report any abnormal wound changes to your physician.