Wound Healing | Coccyx fistula

Wound Healing

There are different possibilities to treat coccyx fistulas surgically. The operations differ not only in their technique and course but also in the form of their later wound healing. The following section will briefly discuss the different surgical methods and wound healing.

1st operation with open wound healing: Open wound healing is also called secondary wound healing. In this operation, the coccyx fistula is opened so that the secretion of pus and blood can drain away. Once this is done, the wound is stained with a dye called methylene blue to make each fistula duct visible.

Then the tissue is cut out over a large area – right into the healthy tissue. The incisions extend to the periosteum of the rump, which is then partially scraped. This minimizes the chance of a relapse.

After the operation, the wound is not sutured up as is usually the case with many other operations, but left open. Therefore this is called open wound healing. Open wound healing can take up to several months.

The wound is simply filled with a tamponade. It has to be changed several times and the patient has to flush the wound with water on his own. However, the advantage of this method is clearly that the rate of recurrence is significantly lower than with conventional wound healing.

Vacuum therapy can accelerate wound healing. However, it is not covered by the statutory health insurance companies. 2. surgery with primary closure: Another surgical procedure, the so-called primary closure, is basically the same as surgery with open wound healing.

There is however a large difference. The wound is not left open afterwards, but sutured. The advantage over the variant with secondary wound healing is definitely a shorter healing time.

The patient naturally finds it more pleasant to have a closed, clean wound suture than an open wound, even in everyday life. However, this has a very big and not to be sneezed at disadvantage: the chance of a relapse is very high.Wound healing disorders and wound infections occur more frequently than with open wound healing. 3. other surgical techniques: Other surgical techniques, such as Karydakis surgery or Bascom pit-picking, do not use open wound healing, but the rate of recurrence and wound healing disorders is also lower than in primary wound closure.

This is due to the fact that some procedures are endoscopic and minimally invasive, which means that the wound area is shifted away from the midline. This is particularly beneficial for wound healing. A disadvantage may be that the optical result is somewhat different than with the other procedures.

However, the recurrence rates are significantly lower, i.e. the chances of healing are much higher than with primary closure, for example. Coccyx fistula surgery is performed under local or general anesthesia. The fistula is split with a scalpel, allowing blood and pus to drain away.

The fistula is then stained with methylene blue so that all of the fistula ducts are clearly visible. This area is cut away generously. Depending on the size and type of fistula, the wound area can be very large.

In secondary wound healing, the wound is not closed, but only filled with a tamponade, so that the wound heals slowly. It can take several months before the large wound is closed in this way. In primary wound healing, the procedure is the same as in the surgical method described above, but at the end of the operation the wound is closed by suturing. This allows the wound to heal more quickly, however, this procedure also often leads to healing disorders and infections of the wound area.