What this experience covers
After many colorectal procedures — fistulotomy, abscess drainage, hemorrhoidectomy, fissurectomy — the wound is deliberately left open rather than stitched closed. This is called healing by secondary intention. The wound heals from the bottom up, gradually filling in with new tissue.
This experience covers what that process is actually like day to day — the timeline, the wound care, the emotions, and the practical challenges people describe.
The pattern
Why the wound is left open
People are often surprised to learn their wound will not be stitched closed. The reason is that closing wounds in the anal area carries a higher risk of infection — the area is difficult to keep sterile, and trapping bacteria inside a closed wound can lead to abscess formation. Leaving the wound open allows it to drain freely and heal cleanly from the inside.
Understanding this helps, but it does not fully prepare people for the reality of managing an open wound for weeks.
The timeline people describe
Healing by secondary intention is slow. This is the hardest part for most people to accept.
- Week 1: The wound looks raw and may produce significant drainage. Pain is typically at its worst. Daily wound care is essential.
- Weeks 2 to 4: Drainage gradually decreases. The wound bed starts to look healthier — pink granulation tissue forming. Pain reduces but is still present.
- Weeks 4 to 8: The wound is visibly smaller. Many people describe a turning point around week four to six where they can see real progress. Drainage is minimal.
- Weeks 8 to 12+: The final stages of healing. The wound may look nearly closed but take additional weeks to fully seal. Some people describe complete healing by eight weeks; others take three to four months.
The daily reality
The most honest accounts describe wound care as the defining feature of recovery. People describe:
- Changing dressings or pads multiple times daily, especially in the first two weeks
- Sitz baths after every bowel movement — essential for keeping the wound clean
- Learning to look at and assess their own wound, which initially feels confronting
- Gradually reducing wound care as healing progresses
What people wish they had known
The overwhelming theme: the timeline. People wish they had understood from the start that this would take weeks to months, not days. Knowing this would have reduced the anxiety and frustration that comes from expecting faster progress.
If something about your recovery does not feel right, or you just want reassurance about what is normal, our chat can help you think it through.
When to contact your doctor
Seek medical attention if you experience:
- Increasing pain after an initial period of improvement
- Wound drainage that becomes foul-smelling, thick, or changes colour
- Fever or chills
- Bleeding that is heavy or increasing
- The wound appearing to get larger rather than smaller
- Any signs of infection — increased redness, warmth, or swelling around the wound