1.What is an anal fistula?
An anorectal fistula is an abnormal channel formed by infection, injury, foreign body and other pathological factors in the perianal space that connects to the skin around the anus. In Chinese medicine, it is called anal leakage. The main clinical features of anal fistula: anal hardening, local repeated breakage and pus flow, pain, moisture, itching, etc.
2.How is an anal fistula formed?
Modern medicine considers anal fistula and perianal abscess as two different pathological stages of purulent infection in the perianal space, with perianal abscess in the acute stage and anal fistula in the chronic stage, which means that anal fistula is the inevitable result of the development of perianal abscess. Firstly, the infection of anal sinus and anal flap causes anal gland infection, if the treatment is not timely, the inflammation spreads to the perianal area and forms perianal inflammation, when the infection spreads to the perianal space, it further forms perianal abscess, the abscess breaks by itself through the perianal skin or rectal mucosa of anal canal, or after incision and drainage of pus, the abscess cavity gradually shrinks and the connective tissue of the abscess cavity wall proliferates, so that the abscess cavity narrows and forms The fistula is a hard, straight or curved wall with a gap in the middle, which is called a fistula, from which pus or thin stool often flows, repeatedly, repeatedly infected, and does not heal over time, thus forming a fistula, which becomes an anal fistula. The first thing you need to do is to get a good idea of what you are getting into.
3, why anal fistula does not heal?
The main reasons why anal fistulas do not heal are the following.
(1) The presence of a primary infected internal opening.
(2) Repeated infection, the fistula wall does not close easily.
(3) The pressure in the rectal cavity is higher than the outside world and the fistula wall is fibrotic, making it difficult to close the fistula lumen.
(4) The external opening of the fistula is small and sometimes closes and collapses, and pus accumulates in the lumen, causing the abscess to re-rupture and form a new branch or fistula.
(5) The fistula traverses the anal sphincter from different heights, and when the sphincter contracts, it hinders the discharge of pus, resulting in poor drainage.
4.What are the treatment methods for anal fistula?
Anal fistula is not self-healing and therefore must be treated surgically.
Whether it is a low, high, simple, complex, blind or hoof fistula, the treatment principle is to cut the fistula, open the wound, protect the sphincter and the function of the anus, and promote healing. The clinical choice of surgical approach is based on the height of the internal orifice and the relationship between the fistula and the anal sphincter. The main surgical procedures are fistulotomy, fistulotomy, and low-cut-high-hanging surgery.
5, why is it easy to recur after anal fistula surgery?
(1) Inaccurate or incorrect positioning of the internal opening, especially in complex anal fistulas.
(2) Artificial creation of the internal opening during surgery, the original internal opening is not opened in time and the source of infection is not removed.
(3) The main focus of the fistula is not opened and the branch is missed.
(4) Poor drainage after surgery.
(5) Incomplete postoperative dressing changes and pseudo-healing of the incision (also known as bridge healing).