Pre-operative Preparation for a Perianal Haematoma Incision and Evacuation procedure
No special pre-operative preparation is required. This is performed as an office procedure. The objective is to incise the skin over the haematoma which allows evacuation of the contained haematoma (clot).
Local anaesthetic is injected in the skin over the haematoma. The skin is incised and the haematoma evacuated, providing almost instantaneous relief. The wound is left open to allow the continued drainage of any further collection of blood.
Post-operative Care following a Perianal Haematoma Incision and Evacuation procedure
Following your procedure there are a number of things of which you need to be aware.
It is inevitable that you will experience some discomfort following your surgery in the region of where the perianal haematoma has been performed. As it is a relatively small incision this discomfort should be no greater than the pain you were experiencing. Take some Panadol or Nurofen. I recommend that you take these initially on a regular basis as directed on the packet. After about 48hrs it should be necessary to take these only as required.
It is important to maintain normal bowel activity after the surgery, but you would not normally expect a bowel motion for the first 2-3 days after your operation. Opening your bowels will increase the level of discomfort initially and it is important to keep yourself regular with an intake of adequate fibre. You should also drink plenty of water. If you feel that you are getting constipated then a fibre supplement such as Metamucil, Mucilax or Normocol should suffice.
A small amount of bleeding in the first two or three days is not unexpected, particularly with defaecation. If it appears excessive then simply apply some pressure with a gauze pad for 15-20mins.
You may experience swelling in the perianal region lasting for a few days but this will subsided of its own accord in due course.
The healing of the perianal haematoma repair wound can be aided by simply cleaning the wound with soap and water in the shower, particularly once again after defaecation. Bathing the area in a warm salt bath may help your level of discomfort but probably won't alter the way the area heals. Infection is most unusual and if it does occur will usually settle of its own accord without the need for antibiotics.
Resuming physical activity is largely one of common sense. Certainly moving around the house and going for short walks in the first couple of days is desirable. Anything more than this will be destined to cause more discomfort. An increase in the level of activity should be guided by the level of discomfort. You should be able to resume your normal day to day activities within a few days, so long as this does not include marked exertion. You should however be able to return to the gym or similar activities within a couple of weeks.
Dr Renaut does not routinely see his patients following this procedure but is happy to do so should the need arise.