This is a classic saying circulated in our department!

A real man is a man who has experienced the pain of hanging anus and touched the depths of his soul, but can still laugh at life.

This is the chicken blood I gave to a crying 16-year-old anal fistula patient three years ago.

Want to know how painful it is?

Anal fistula is divided into two types:

One is that the anus and rectum communicate with nearby organs, such as rectovaginal fistula and rectovaginal fistula.

One is that the anorectum communicates with the perianal skin, which is what we often call anal fistula.

Simply put, anal fistula is an abscess around the rectum and anal canal that is not well drained and difficult to heal. After a long time, scar tissue is formed, which further hinders healing and produces fistula, which is anal fistula. The inner mouth is in the anorectal tube and the outer mouth is in the perianal skin.

Anal fistula connects anorectum and peripheral skin, so that feces always enter the fistula from the breach of rectum or anal canal, which makes the fistula fester and infect, and the perianal skin oozes pus. If the fistula is large, a small amount of feces can also be seen oozing from the skin.

To determine whether it is anal fistula, put a piece of gauze in the anus and put some methylene blue in the outer mouth to see if the gauze is dyed. If there is, it proves that there is an internal orifice, which is an anal fistula.

Okay, get to the point.

Anal fistula surgery is divided into two types, with different methods and different sourness.

Incision or excision of anal fistula

1. lithotomy position, anesthesia.

2. Find the inner mouth and use methylene blue, as mentioned above.

3. The probe extends from the perianal external orifice to the rectal internal orifice, and then bends out from the anus.

4. Cut all the peripheral skin and subcutaneous tissue of the inner and outer doors until the fistula, and completely remove the fistula.

5. The wound was not stitched, and it was filled with vaseline gauze. Then there is the painful dressing change every day. Facing this big wound every day, the patient is suffering, and I am more painful.

Wipe fresh granulation tissue for him every day, just like caring for his little heart, and pray that it will not be infected. If the edge of the wound adheres, it should be cut again to make the wound grow from the inside out, otherwise it will form a sinus. The perineum is more sensitive. When I see the patient's sour howl, I have to rub it and hold on. Alas, sometimes I really can't bear to do it.

Change the dressing frequently, use some antibiotics, and then pay attention to cleaning yourself. Simple anal fistula can heal slowly in about half a month if there is no infection. Complicated anal fistula,,, That depends.

After 24 hours, take some laxatives to soften the stool and help excrete. Every time I defecate, the feeling of dilating anus and the feeling of foreign body irritating the wound. . . . . I wonder if it's a little high?

2. Anal thread hanging

Well, I have to hack my brother. After several years, he still bears a grudge against me as a senior.

Said that my younger brother is still a graduate student and hasn't gone to the clinic yet. He knows nothing. He has a small piece of fresh meat and a shy scholar. One night when I was on duty, he mysteriously came to me and said with a wretched face:

"Brother, there is something I want you to do!"

"What is it?"

Hesitate for a long time, annoying.

"You have a fart, I have to write a medical record."

"Well, I seem to have a little anal fistula, and my position is relatively low. Please take a look at it for me. "

I didn't laugh because I had internal injuries.

Pulled into the dressing room, Corey had no probe, so he had to take out a debridement bag. The finger in the anus had touched the head end of the vascular clamp, which was really low.

"Brother, if this anal fistula is not treated, it is generally incurable. This is the situation in the ward. Otherwise, senior brother will hang a line for you, which is simple and convenient. If the cut is not good, it will be bad if the chrysanthemum is broken. "

"Hang up the line? Is that convenient? "

"Yes, yes, and you don't have to go to the operating room, you can do it in the ward, and the effect is good."

"Does it hurt?"

"Nothing, there is anesthetic."

"Oh, all right."

Let him pose:

1. skin preparation and disinfection, lidocaine local anesthesia.

2. I can't find a thin rubber band in the ward, so I use a red catheter directly (it's a little thick. Well, I admit I'm a little tough)

3. Take the groove clamp as a probe, probe from the outer port to the inner port, clamp the catheter, pull the catheter head end in from the inner port, and pull out the outer port.

4. Lift the catheter and cut the whole skin inside and outside. Tighten the catheter and ligate it along the subcutaneous tissue. In this way, the ligated tissue will be ischemic and necrotic, and fresh tissue will gradually generate filled necrotic tissue.

5. Cover the wound with vaseline. It's done.

Wait a moment, after the anesthetic, teacher younger brother said:

"Brother, it seems to hurt!"

"It's okay that's ok, later. Come and change medicine every day. "

"Oh. By the way, brother, don't talk about this in the department. Will you change my dressing when I come over? "

"benefits?"

"I'll treat you to dinner for a week!"

"yes."

After that, he left slowly, but he didn't know that he betrayed him by walking. What he doesn't know is that all this is just the beginning.

Young, that's terrible.

The next day, I watched him turn around and went to the clinic to get him some antibiotics and potassium permanganate. When changing the medicine, Aner wiped it with iodine, and obviously saw that his chrysanthemum was tight, and he gasped. As soon as the catheter was pulled, it grinned and groaned at once.

Thinking that he has to go through an inhuman dressing change every day,

Necrotic tissue tied in circles every day is inflamed and stimulates the anus,

Go to the toilet every day, dilate your anus,

The feeling of brushing chrysanthemums with toilet paper after going to the toilet,

You have to take a bath with potassium permanganate afterwards.

After more than ten days, the catheter fell off and needed to be changed.

……

That sour taste, alas, as a senior really hurts!

"Brother, didn't you say it didn't hurt so much? Why is it so painful? "

"A little bit, a little bit, you can bear it, it will be fine soon!"

After almost 20 days, my brother came to see me for dressing change every day. His eyes changed from the initial lamb to fear, and finally gnashed his teeth, full of fierce light. A bottle of red bull, which brought filial piety every day, disappeared without a trace on the fourth day.

That's right. You stood me up for a week's meal.

What's even more irritating is that the 100 yuan I bought him medicine has not been returned to me yet.

Sure enough, the pit is full of senior brothers! ! !