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Rectal surgery closure and expected recovery time

Posted by Hot for teacher, on Wed Apr 24, 2013 3:04 pm
I had ileostomy surgery with a closure to the rectum at the end of October 2012.  It is now six months later and the rectal wound has not closed and I still have pain and drainage associated with it.  I used a wound vac for 6 weeks and it sped up the process but it was too shallow to continue with the vac.  Home health and my doctor agreed it would take several more months before it closed completely. I am unable to do any squatting or lifting of any kind due to 2 other surgeries and the wound attempting to close.  Even a little bit of excessive walking or minor housecleaning seems to cause more problems for the new tissue trying to heal.  Do any of you have a timeline that I can anticipate or suggestions for healing.  My initial doctor that did the ileostomy did not stitch it up effectively and I was left with a 6x2x4 cm opening.  Is that normal?????  
Reply by Penguins7, on Wed Apr 24, 2013 4:23 pm
I too had ileostomy surgery with a closure to the rectum in October 2012. I currently have a wound that will not close up either and it is frustrating to say the least.  Mine was created as a result of my surgery and pelvic abscess infection formed.  It is still 10cm deep and drains continious and i asked my doctor last week what will speed up the healing process.  My Doc was not sure......  It amazes me the lack of knowledge Doctors have about healing.  I requested a CAT scan to see what is going on in this area.  I know exactly what you are experiencing.  Good luck.  If anyone has any suggestions for healing a wound it would be appreciated.  Penguins7
Reply by Primeboy, on Wed Apr 24, 2013 10:54 pm
This may not help either of you (Penguins and Hot) but my GI was not keen on closure. His advice at the time was that closure is a very complicated procedure. That was enough for me. I decided to leave well enough alone; and, happily, my healing was rapid.  Since then, my only issue with open endedness is leakage of mucus which I can manage nicely. So, my two cents here is to advise ostomates who are contemplating closure to carefully weigh the benefits against the risks.    PB
Reply by Anoniem18, on Thu Apr 25, 2013 3:59 am
It is almost embarrassing to be so lucky but I too had a closure of the rectum and while it took longer than expected and caused postponement of radiation the wound did heal. I am not sure if the treatment was the reason for the success but I did have a weekly visit of the home care nurse who dressed the wound every week, I am sure I would have been unable to perform the procedure the same way. One thing they used was the medicine prescribed: Flamazine made by smith&nephew - (Silver Sulfadiazine 1%). Luckily the pharmacy did not have the 100 gram tube (about small toothpaste size), They gave me 5 20 gram tubes. BTW this stuff works great for burns including radiation burns - apply 2 - 3 times a day for which it was prescribed. I used it when I tried to pick up a sandwich grill assuming the back was insulated; it wasn't a minute after applying the pain subsided.
You might want to talk to your doctor or to your pharmacist. Obviously my surgeon has to be one of the best especially since I just came home from the hospital where he removed my gallbladder and repaired a hernia around my stoma and I was home by 4:00 PM went in at 7:00AM and he removed a gallstone in February at 10:30 PM. Dr. Igor Goussev is my guy just fantastic.

Last edited by Anoniem18 on Sat Apr 27, 2013 7:46 pm; edited 3 times in total
Reply by Steve7809, on Thu Apr 25, 2013 4:09 am
Hello Hot for teacher. I had my ilio and closure in july of 09' ( hence the four digits after my name). It was a very long, slow heal without a wound vac. After about a year it was not really making any progress at all. At that point the wound small. Just big enough to fit a Qtip with an opened up 2x2 guaze about an inch and a eighth deep. sorry, Im not good with metrics if you could do the conversion.) The doctor said it was turning to scar tissue and it wouldnt close up more and that I could either live with it or have another go at it and cut it out and try again. Primeboy is right. It is just a little mucus leakage and if you can deal with that thats great. Me personally, after two years i had had enough of it and wanted it over with. I went under the knife, AGAIN, and it closed up great and I am happy with it. My suggestion to you? ATTACK IT AGRESSIVELY! Keep it dry. I should have. Even if it means changing the guaze every 2 or 3 hours. wounds love moisture. Dry. Of course run this advice by your doctor and ask him or her for some silvasorb. I believe its silver nitrate. Its anti-microbial and promotes healing. I think you still have a chance to close it up before it turns to scar. But Im not a doctor I just play one in the bedroom ). lol. Sorry, couldnt resist. Seriosly DRY DRY DRY. Good luck keep us posted. SA.
Reply by Lobster, on Thu Apr 25, 2013 8:06 am
my rectum healed splendidly, so much so the that 8 weeks after my initial surgery when i went back for a check they were bringing people in to look and marvel. However, it never fully healed and I was referred to a plastic surgeon. He said it was not uncommon for the rectum to heal 90-95% and then stop for whatever reason. I am in the middle of the Xray bits of investigation at the moment. I think the plan is to stitch up/close the cavity and then when that is done I'll have a skin graft to seal it up finally and then no more yukky stuff coming out (albeit very little these days after 5 years).
As for timescales for healing I don't know but if I do find out I'll post it.
Reply by Shash, on Thu Apr 25, 2013 6:49 pm
Hi there
I actually had a colectomy done in Oct 2011 (resulting in permanent iliostomy) and then a second procedure to remove the rectal stump the following summer.  The closing of the rectum healed very, very well and I have had no problems at all.  Prior to having the rectum closed I had a lot of leakage and subsequent skin irritation so quality of life is much better now that the rectum has been closed (at least in my case!)
Best of luck
Reply by Hot for teacher, on Fri Apr 26, 2013 12:14 am
Thank you all for the insight.  It helps to hear from others in my situation.  My gastro doctor just blows it off and tells me to keep changing the gauze/pads often to keep it dry.  Which I do on a regular basis.  However, I am extremely limited on any kind of physical activity of lifting or squatting down, exercise, riding a bike, pulling objects or even handling my own luggage bc my rectal skin is so thin and weak and tears easily.  I am basically unable to even do some simple household chores for fear of ripping it open even more.  Also, when I attempt more physical things i always have tremendous amounts of drainage.  My surgeon seems to think it should be a couple of more months.  He did discuss going back in to repair the openings as long as there wasn't any infection in the openings.
One more question, did you all have pain sitting the entire time the area was open?
Reply by Anoniem18, on Sat Apr 27, 2013 7:41 pm
One thing I did do just after the operation is to place some gauze tape across the cheeks to prevent any possbile tearing and that worked very well. The home care nurse at first was skeptical; concerned about keeping the area dry. I didn't use the tape to pull tight just to prevent from pulling too far. And I used the Flamazine ointment.
Past Member
Reply by Past Member, on Sat May 04, 2013 5:23 am
Hi there,
sorry to hear things are tough for you.
I had a colostomy in March 2010 after 28 years of colitis, followed by Proctectomy in June the same year. It took at least two months for the wound to heal but is now fine. I just remember sitting on chairs as little as possible and allowing as much air to the wound as possible. As someone else said, keeping the wound dry and clean seems crucial, so dressing gown with no underwear for weeks, or nothing on at all from the waist down if no-one else is around!

It all takes a long time and I know I wanted to get back to normal busy life as soon as possible but I think you have to give yourself permission to lie around for as long as it takes.

I had a lot of pain from sitting and used a 'doughnut' cushion for over a year, and still do on long drives. I had nerve damage from steroid enema use in my rectum for years so that took a long time to settle down.

I hope it works out for you
Reply by DH, on Sat May 04, 2013 11:21 am
Hi , I had the same problem after having my rectum and anus removed and sewn up.I didn't think my ass end would ever heal. I had a tiny little hole back there that didn't seem to want to close. My surgeon said that because air doesn't reach that area, It would take several months to heal. So I waited it out and wondered if I stick my butt out the window would it speed the healing process. Of course I didn't do that. But be patien't it will heal.   Good luck!
Reply by Penguins7, on Sun May 05, 2013 4:25 pm
Hi Donna,  Thanks for the response.  It has been frustrating to say the least.  Rod
Reply by Susanne, on Tue Jan 02, 2018 2:29 pm

Interesting posts.  I also had a big hole in my ass after APR surgery, rectum, sphincter muscle and anus all gone. Have a permanent colostomy in October 2017.  Then had abscess, I had to do sitzbaths, and now the wound is finally getting smaller, as first I had home nurses coming to change the dressing, now I learned how to do it myself and go to the hospital for woundcare twice a week. This sure takes long but at first the hole was 12 cm long - now I have to cut the gauze to put it in.  And interesting enough, they say the gauze always needs to be wet otherwise it would not heal.  And it does heal nicely now and I change the gauze daily with sterile water which they gave me.  It is 4 cm now and I hope it will be closed soon as I am sick and tired of wearing pads down there.  Looking after irrigation and stoma is work enough.

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