Reasons for the formation of a ligature fistula and ways to eliminate it

After surgery, a fistula can occur for many reasons. It usually appears after operations on the abdominal and tubular organs. The fistula may not heal for a long time, leading to damage to many parts of the body and, in some cases, to the formation of malignant tumors. The formation of a non-healing wound indicates that an inflammatory process is taking place in the body.

Causes of fistulas after surgery

If during a surgical intervention a foreign body enters the body, causing inflammation and infection, postoperative complications may begin. There are many reasons for this. One of them is a violation of the removal of purulent masses from the fistula channel. The occurrence of an inflammatory process may be due to the difficulty in the exit of purulent masses due to the narrowness of the channel, the presence in the drainage fluid of the products of the work of the organ that has undergone surgical intervention. In addition, the reasons for the formation of non-healing postoperative wounds can be improper operation and infection in the open wound.

A foreign body that has entered the human body begins to be rejected. As a result, the immune system is weakened, the body ceases to resist infections. All this delays the recovery period after surgery and causes encapsulation - infection of the operated organ. In addition, a foreign body in the body causes suppuration, which serves as an additional factor interfering with the healing of the suture. Such cases include bullet wounds, closed fractures and other injuries to the body. Ligature fistulas occur when the body rejects the threads that fasten the edges of the wound.

The appearance of a fistula on the seam can occur both in the first days after the operation, and many years later. It depends on the severity of the inflammatory process and the depth of tissue incision. The fistula can be both external (coming to the surface and in contact with the external environment) and internal (the fistula channel goes into the cavity of the organ).

Postoperative fistula can be created artificially. It is introduced into the digestive system for artificial nutrition of the patient. An artificial fistula of the rectum is formed for the unhindered removal of feces.

Fistulas in the human body can form in various chronic or acute diseases that require urgent surgical intervention.

If a cyst or abscess occurs in the cavity of an organ, bone or muscle tissue (with the further appearance of a fistulous canal), doctors excise the suture again. If the inflammation is not eliminated, the infection becomes more severe and leads to the formation of new fistulas.

Types of postoperative fistulas

A ligature fistula is formed after the application of non-absorbable sutures and with further suppuration of the sutures. They exist until the surgical threads are completely removed and are able not to heal for a sufficiently long time. A fistula resulting from tissue infection is a consequence of non-compliance with the rules of antiseptic treatment of the suture or subsequent divergence of the sutures.

Fistulas of the rectum or genitourinary system lead to a deterioration in the general condition of the body. The excretion of feces and urine to the outside is accompanied by an unpleasant odor, which causes a lot of inconvenience to a person. Bronchial fistulas are a complication of surgery to remove part of the lung. So far, there are no more advanced ways of suturing the bronchi.

Methods of treatment of postoperative fistulas

In the presence of strong immunity and the absence of infection of the operated tissues, the recovery period ends successfully. However, in some cases, the seam may become inflamed. The resulting ligature fistula is treated with surgical methods. When diagnosing ligature fistulas, doctors use methods to determine the location of the foreign body that caused inflammation and the development of the fistula. Such methods include double shots, the method of four points and tangent planes. When the fistula is opened, the foreign body itself and purulent masses are removed through its canal.

With a successful outcome of the treatment, the inflammation is eliminated and the fistula resolves itself. Spontaneously, this process can occur in very rare cases. Usually it takes a lot of time, the disease can become chronic and cause serious complications. The number of fistulas formed depends on the number of infected ligatures and the vital activity of pathogens. Depending on this, the frequency of the periodicity of the exit of purulent masses from the fistulous canal changes. Ligature fistula is treated both medically and surgically.

Conservative treatment is recommended with a minimum number of fistulas and pus secreted from them. The essence of the treatment is the gradual removal of dead tissue that interferes with wound healing and the removal of surgical sutures. In addition, the patient is recommended to take drugs that strengthen the immune system. For faster and more effective treatment, it is necessary to take antibiotics and treat the affected area with antiseptics.

The seam is usually treated with hydrogen peroxide or furacilin solution. This helps to remove purulent discharge, protect the wound from infection and speed up its healing. In inpatient treatment, constant ultrasound monitoring is carried out, which is considered the most gentle method of treatment.

Surgical intervention is prescribed for patients with a large number of fistulas and a fairly intense outflow of purulent masses. Also, this method is used when there is a foreign body in the body and serious postoperative complications. To prevent the occurrence of ligature fistulas after surgery, it is recommended not to use silk threads for suturing and to observe antiseptic measures.

Surgical treatment of such complications involves excision of the fistulous canal, cauterization or removal of granular tissues along the entire canal with a curette. In addition, the surgeon removes the festering suture material.

If necessary, an operation is performed over the suture to remove it, along with surgical threads and fistulas.

When one of the ligatures becomes inflamed, only part of the suture is excised and removed. After that, the sutures are re-applied.

If the treatment of postoperative complications is not started in time, they can turn into a chronic form and lead the patient to disability. Treatment of a ligature fistula should begin when its first symptoms appear.

Treatment of a fistula with folk remedies

In the early stages of the disease, treatment with folk methods can be quite effective. Good results are obtained by treatment with a mixture of vodka and olive oil. The mixture must be used to treat the affected areas. After performing this procedure, a cabbage leaf is applied to help draw out the pus. The course of treatment lasts several weeks, after which the fistulous canal disappears.

Fistulas on the skin can be cured with a mixture of aloe juice and mummy. Mummy should be soaked in warm water, the resulting solution mixed with aloe juice. This medicine is used in the form of gauze compresses. A good result is also given by compresses with a decoction of St. John's wort. 2 tbsp. spoons of dry grass pour a glass of water and bring to a boil. After that, the broth is filtered and used for compresses. For treatment, you can also use fresh leaves of St. John's wort. They are placed on a film that is applied to the affected area. The course of treatment lasts until the wound is completely healed.

Fistula of the rectum can also be cured by folk methods. Mix a small amount of toadflax flowers, water pepper leaves and oak bark. The mixture must be cooked over low heat in an oven. The finished ointment with a cotton swab lubricates the affected areas. The course of treatment lasts about 3 weeks. The same method can be used in the treatment of vaginal fistulas. Such an ointment can also be prepared using onions.

A fistula is a narrow, unnatural canal that forms in tissues as a result of an ulcer process and connects hollow cavities and organs.

There are two types of fistulas: appearing after surgery or formed as a result of certain pathological processes occurring in the body.

Consider the first type of fistula using the example of creating a suture after a caesarean section. Like any surgical intervention, this procedure can have some unpleasant consequences and complications. One of them is the appearance of fistulas on the postoperative suture.

Such a fistula is called ligature.

It is the result of the introduction of infection into the suture, and also as a reaction of the body to foreign material - a surgical thread. (Hence the name: ligature - thread). It can appear at different times after the operation: from a few days to months and even years. The occurrence is infectious, as well as allergic.

First, the bacteria get on the surgical thread. They cause suppuration of tissues and further compaction. Not one, but several fistulas may form. The latter depends on the circumstances and individual characteristics of the patient.

Reasons for the appearance

Consider the reasons why such a fistula may appear.

In general, the appearance of a ligature fistula is characterized by inflammatory process in the suture area formed after the operation. The consequences can be ambiguous: the patient can recover very quickly, but there is a possibility of severe intoxication of the body, leading to serious consequences and even disability. The main thing is not to start the disease, and start treatment in a timely manner.

Symptoms

Treatment

Diagnosing a fistula is quite easy after examination by a specialist, as well as on the basis of complaints from a sick woman. Treatment in the hospital must begin immediately. Self-treatment and any self-treatment of the wound are excluded. This can lead to more infection.

The infection is removed by a qualified doctor using conservative therapy, i.e. treatment with various antiseptics, antibacterial drugs and solutions.

Treatment is accompanied by mandatory intake of antibiotics, immunostimulants, anti-inflammatory drugs and vitamins. As a result, the fistula is tightened by itself.

In more severe cases shown surgical removal of the thread from the fistula. It happens in the following way.

There are methods for removing the thread through the fistula canal, i.e. without cuts, using specialized tools. Modern methods allow the procedure to be carried out under ultrasound supervision. As a result, the operation is targeted and more gentle for the woman.

Prevention of fistula

Fistula on the neck

It is the result of a violation of intrauterine development of the fetus. However, such a fistula can also form as a result of an illness or neck injury, i.e. be purchased. It is diagnosed mainly in children.

One of the causes of congenital pathology is the incorrect development of the gill arches at the stage of the embryo.

Symptoms

Parents immediately notice a small hole in the baby's neck, from which fluid is released. By the time a bacterial infection is attached, the discharge becomes yellow or green, and a pungent odor may appear. As a result of the inflammatory process, the child's temperature increases, his condition begins to deteriorate. The site of the hole swells and turns red. There is a pain effect.

Treatment

In the case of congenital pathology, the treatment of the child is delayed until at least 3 years, and ideally - up to 5-7 years. However, this is only possible if there is no inflammatory reaction. Otherwise, urgent intervention of the surgeon is necessary.

Acquired fistulas are treated immediately. The operation takes place under general anesthesia. The canal walls are removed, followed by wound treatment and suturing. Modern methods allow the procedure to be performed using new endoscopic instruments and under local anesthesia, which greatly simplifies the operation for both the doctor and the patient. The choice of type of treatment depends on the individual characteristics and age of the child.

Usually, recovery is quick and takes no more than a week. And thanks to the latest suture materials, patches, the seams on the neck will be almost invisible.

Specialists give in most cases a good prognosis of neck fistulas. But there are exceptions, for example, the recurrence of a fistula after a poorly performed operation.

It is strictly forbidden to self-medicate at home. This will not bring any results, at best, and at worst, it will only aggravate the situation due to the occurrence of additional infection, which will lead to serious complications.

It occurs as a result of inflammation and suppuration of non-absorbable surgical sutures, which sew tissues (fascia, etc.) during various operations.

During surgical interventions, some tissues (muscles, subcutaneous tissue) are sutured with absorbable sutures, and some (aponeurosis, tendons, etc.) are sutured with non-absorbable sutures. such tissues fuse slowly and are subject to heavy loads. As a rule, non-absorbable threads remain forever in the tissues without causing any problems, but in rare cases they suppurate, then a small abscess appears in the thread area, which opens through a small hole in the skin and a fistula forms.

Causes of ligature fistulas.

The main reason for the appearance of ligature fistulas is the infection of the thread. Most often, it occurs during operations on hollow organs - the intestine, stomach, gallbladder, etc. During these interventions, the lumen of hollow organs is opened, and even with the most correct operation, infection cannot be avoided to one degree or another. Sometimes it happens that infection is caused by non-compliance with the rules of asepsis during surgery or poor-quality suture material, but such cases are quite rare. Further, everything depends on the aggressiveness of the microbe, the immune status of the body. If the microbial agent is aggressive, and the immune forces are not enough to suppress it, the thread suppurates. If the thread festered, then until the thread is rejected, the purulent process does not stop, then escalating, then calming down.

Symptoms, diagnosis of ligature fistula.

The ligature fistula appears at different times after the operation - from several days to several months and even years. In the area of ​​the postoperative scar, redness, moderate pain occurs, body temperature may rise. These phenomena are associated with suppuration and the appearance of an accumulation of pus under the skin - a ligature abscess. After a few days, the abscess spontaneously erupts on the skin in the area of ​​the scar, pus flows out, and a small hole remains on the skin with leakage of a cloudy liquid - this is the ligature fistula. If more than one thread festered, there may be several fistulas. Against the background of treatment, the fistula may close, but if the thread is not torn away (does not come out), the fistula inevitably reopens. So, periodically opening and closing, the fistula can exist for several months and even years, until the thread is rejected by itself, or is removed by the surgeon.

Photo below - ligature fistula after knee surgery

Below is the same patient, a photo of the fistula opening, a tearing ligature is visible.

Treatment of ligature fistula.

With the initial manifestations in the form of a ligature abscess, a small skin incision is made to drain the pus, because. it is not advisable to wait until the pus erupts on its own due to the risk of suppuration of the surrounding tissues and the formation of phlegmon - diffuse inflammation of the subcutaneous tissue. After opening the abscess, they usually try to blindly get the ligature with a clamp. If this succeeds, then after cleansing the wound, the fistula closes forever. If the ligature cannot be obtained, dressings with levomekol ointment are prescribed, against which the inflammation subsides, the fistula may temporarily close. With a new inflammation, they again try to get the ligature, sooner or later they succeed. It is possible to make a wide incision in the area of ​​the fistula, try to find the inflamed thread and remove it, but this is not always possible, moreover, during extensive intervention, there is a risk of infection of neighboring threads with the subsequent formation of new fistulas.

Summarizing the above, we can say that ligature fistula- a rare complication of abdominal and other surgical interventions, which is not life-threatening, but can disturb the patient for quite a long time, up to rejection or removal of a festering thread.

MAKE AN APPOINTMENT

A fistula is a pathological channel that connects a hollow organ and the external environment or two hollow organs. Most often appearsfistula after surgery. Treatment of this formation is quite long and painful. That is why the patient must strictly adhere to the doctor's instructions.

The fistula is a hollow neoplasm, which in its appearance resembles a deep wound. In accordance with the characteristics of the development of neoplasms, they can be:

• labial. In this case, there is an fusion of fistulas and skin, as well as muscle tissue. Removal of fistulas is carried out using a surgical method.
• Complete. It is characterized by the presence of two exits, which makes it possible to most effectively combat the inflammatory process.
• tubular. It is a fully formed channel, from which there is a constant discharge of feces, pus and mucus.
• Incomplete. The neoplasm is characterized by one exit, the location of which is the abdominal cavity. With this type of fistula, pathogenic microflora multiplies, and inflammation also aggravates.
• Granulating. With this type of fistula, granulation tissue is formed. With this pathological process, swelling and hyperemia are often observed.

About, what is a fistula after surgeryonly the doctor knows. After an appropriate diagnosis, a specialist will be able to determine the type of formation, which will positively affect the treatment process.

Reasons for the appearance

Postoperative fistulasmay develop for a variety of reasons. Most often, pathology is observed against the background of an infectious process that enters the human body through sutures and wounds. After a surgical intervention, the human body may reject the thread, which is explained by intolerance to its components. Against this background, it appearspostoperative fistula. The development of neoplasms can be diagnosed in the presence of other provoking factors, which include:

• High immune reactivity of the body;
• Elderly age;
• Chronic specific infection;
• hospital infection;
• Oncological diseases.

If vitamins and minerals enter the human body in insufficient quantities, this leads to the formation of fistulas.. Postoperative fistula, treatmentwhich is very long, appears in violation of the metabolism - diabetes, metabolic syndrome, obesity.

Before, how to treat a fistula after surgery, it is necessary to determine the cause of its occurrence. Therapy of pathology should be directed to its elimination.

Symptoms

Fistulas after surgerycharacterized by the presence of certain features. Initially, the appearance of a seal on the skin around the size is observed. There is pain on palpation. In some patients, the appearance of pronounced tubercles is diagnosed, which is used to secrete the infiltrate. Reddening of the skin may be observed at the site of infection of the scar.

The pathological process is often accompanied by a sharp increase in body temperature. This is due to the course of the inflammatory process in the human body. It is impossible to bring down the temperature to a normal value. Fistulas are accompanied by a purulent process. With untimely treatment of pathology, the size of the abscess increases significantly. In patients, there is a tightening of the fistulous opening for a certain period. This is followed by the development of inflammation.

Fistulas are characterized by the presence of certain signs. When they appear, patients are advised to immediately consult a doctor. Timely treatment of the disease will eliminate the possibility of side effects.

Features of therapy

Fistula treatment after surgeryin most cases requires surgical intervention. Initially, the surgical field is treated with special antiseptic solutions, which will eliminate the possibility of infection. Surgery requires the use of local therapy. In order for the surgeon to find the course of the fistula as quickly as possible, a dye solution is introduced into it.

The surgeon removes the fistula with a scalpel. All other actions of specialists are aimed at stopping bleeding. After that, it is recommended to wash the wound with a solution with an antiseptic effect. Postoperative sutures are applied to the wound. In this case, it is recommended to use active drainage.

The treatment of postoperative fistulas requires the use of not only surgical intervention, but also appropriate medications. In most cases, patients are prescribed antibiotics and anti-inflammatory drugs:

• Diclofenac;
• Nimesila;
• Dicloberla.

In order to speed up the healing process of wounds, the use of Troxevasin or Methyluracil ointment is recommended. It is also recommended to use preparations that are of plant origin - aloe, sea buckthorn oil, etc.

That, how long does it take for a fistula to heal after surgerydirectly depends on the characteristics of the rehabilitation period. Patients are recommended daily hygiene procedures in the area of ​​the operation. The patient is advised to disinfect the sutures daily with the help of special preparations. The patient's diet should be rich in fiber, which will eliminate the possibility of constipation. In the postoperative period, it is recommended to exclude heavy physical exertion. Prolonged work in a sitting position should be abandoned for three months.

How does it appear fistula after surgery, what is itonly the doctor knows. That is why, if neoplasms occur, it is necessary to seek help from a doctor who will determine the type of formation and prescribe rational therapy.

Most surgical interventions end successfully: after suturing, the tissues gradually heal, and as a result, only a small scar remains on the body. But sometimes something goes wrong in this process, and a ligature fistula may appear.

A ligature move appeared: what is it?

The term "ligature fistula" is used by physicians to refer to a pathological course that has formed in the area of ​​​​the superimposed suture material, which, in turn, was used to fasten (stitch) the tissues at the site of the surgical intervention. Such a violation is accompanied by the development of the inflammatory process and suppuration. Among all possible complications after surgery, ligature fistula is considered one of the most common - a similar problem is recorded in 5% of patients who have undergone various surgical interventions.

Most often, the ligature course appears after manipulations on hollow organs localized in the abdominal cavity or in the pelvic area, since the risk of infection during such operations is the highest. The fistula is extremely superficial, but sometimes it is formed at a rather considerable depth.

Causes of an abscess on a postoperative scar

Doctors claim that the main reason for the formation of a ligature fistula lies in the body's attempt to reject a foreign body, represented by a thread that the surgeon used to suture tissues cut during the operation. Most often, pathological processes of this kind occur after the use of silk threads, an order of magnitude less often, lavsan or nylon material becomes the culprit. There is evidence that an abscess can also form when catgut is used, although it is an absorbable thread. At the same time, Vicryl or Prolene threads are practically unable to cause an inflammatory process.

As for the factors that can provoke the formation of a ligature fistula, among them are:

• Introduction of infection. Such a development of events is possible if pathogenic microorganisms penetrate to the suture material due to inflammation of the wound left after the operation. The infection can spread due to insufficient sterility of the surgical field or the instruments used. It can also be provoked by the patient's insufficient compliance with medical recommendations, the accidental addition of a so-called hospital infection, or a significant decrease in the body's defenses (exhaustion, etc.). In rare cases, infectious agents enter the body already on the thread if doctors have violated the rules of sterility.
• Development of immune rejection. The natural activity of the immune system can lead to the rejection of a foreign body, which, in fact, is a suture material. The risk of such a problem depends solely on the individual characteristics of the patient and it is impossible to predict its occurrence.
• Sewing of a hollow organ. A similar situation can happen if the doctor accidentally captures the entire wall of the organ, which is accompanied by the penetration of the thread into its lumen. As a result, the suture material comes into contact with the non-sterile filling of the organ and, naturally, becomes infected. Pathogenic microorganisms gradually spread throughout the thread, activating the inflammatory process.

Regardless of the cause of its formation, a fistula can permanently disrupt the patient's ability to work, aggravating the course of the underlying ailment.

Pathogenesis

If the suture heals normally, scar connective tissue cells gradually form around the threads, the suture material is surrounded by a capsule. If a purulent-inflammatory process develops, normal healing does not occur. Instead of a capsule, a thread surrounds an abscess (abscess). Over time, it increases in size and opens in the area of ​​the postoperative scar - a fistula is formed. Due to the presence of such a move, there is a decrease in the phenomena of an acute inflammatory process, because the contents of the abscess are constantly leaving. The suture material may be in a normal place or move along the fistulous tract.

Features of ligature fistulas:

• They can be formed with equal probability when suturing superficial tissues (for example, on the leg or arm) or in the depth of the wound (during operations on the peritoneum or pelvic organs).
• Deeply localized ligature passages can involve internal organs in a purulent-inflammatory process.
• They may appear years, months or weeks after the intervention.
• They may present with various symptoms.

If the thread comes out on its own or is removed surgically, the cause of the inflammatory process disappears, as a result of which the fistula is successfully closed. However, if this does not happen, the inflammation constantly recurs and may be complicated by the addition of a secondary infection. But even with successful rejection of the thread, suppuration of the wound can occur.

Symptoms of an abscess on the seam

Abscess formation can occur after the patient has been successfully discharged from the hospital, even after several years. The pathological process can make itself felt by local and general disorders:

• Painful sensations in the projection of the location of the infected suture material.
• Weakness, a feeling of weakness, an increase in temperature.
• The formation of a painful induration in the projection of the postoperative scar.
• A change in the color of the skin over the site of inflammation. Most often, the skin becomes purple or cyanotic.
• A few days after the development of primary symptoms, a spontaneous breakthrough of the abscess occurs.
• A medium-sized passage is formed through which serous-purulent fluid (mass) is released in a small volume. If there are surgical sutures on the body, then a typical serous fluid begins to stand out from under them, and then it is replaced by pus.
• After a breakthrough, unpleasant symptoms disappear sharply, the severity of inflammation decreases.

If the thread remains in the wound, the fistula may periodically close and open. But after the successful removal of the suture material, the tissues heal successfully (in the absence of complications).

Complications

A ligature fistula is able to go away on its own, but in some situations its formation can result in quite serious complications:

• Secondary infection, which will be accompanied by the spread of a purulent process.
• Skin dermatitis due to leakage of secretions from the ligature passage.
• Hyperpigmentation of the skin at the site of injury.
• The development of superficial or deep ulcers.
• The defeat of nearby organs, both as a result of a purulent inflammatory process, and due to unsuccessful extraction of the suture material by a surgeon.
• Eventration (prolapse) of internal organs through a defect in the wall of the peritoneum. A similar situation can occur as a result of purulent fusion of tissues.
• Sepsis.
• Lethal outcome.

At the slightest suspicion of the development of an inflammatory process in the suture area, it is necessary to seek medical help, even if quite a lot of time has passed after the operation.

Diagnostics

Usually, with superficial fistulous passages, there are no difficulties in their diagnosis. For this, only a medical examination in a dressing room is enough. Immediately after examining the fistulous tract, the doctor may even remove the ligature. But if the fistulous tract is tortuous or not typically located, additional research methods may be required.

To determine the clear localization of the fistula, the presence or absence of complications, ultrasound is performed.

On the stomach

When a fistulous tract is formed in the peritoneal region, it becomes necessary to perform fistulography. Such a study allows us to find out the depth and features of the form of the resulting passage. The specialist injects a contrast agent into the cavity of the fistula, after which he takes several x-rays in various projections. Ultrasound can also be used for this purpose.

How to cure?

Most often, it is possible to cope with a ligature fistula only through surgical intervention. You definitely cannot do without the help of surgeons if the pathological course exists for a long time. In parallel with the surgical removal of the ligature, drug treatment is carried out. Only sometimes doctors can try to get by with only methods of conservative therapy.

Conservative treatment

For the treatment of ligature fistula, various groups of medicines can be used:

• Local antiseptic preparations. Usually, preference is given to water-soluble ointments, for example, Levosin, Levomekol or Trimistan, as well as fine powders, in particular, Baneocin and Gentaxan. Fat-based ointments (for example, the well-known Vishnevsky ointment) can impede the outflow of pus, so their use is not recommended, especially if there is a significant amount of purulent discharge.
• Antibacterial medicines. Preference is given to drugs with a wide spectrum of action: ampicillin or ceftriaxone.
• Enzymes to eliminate dead tissue. Trypsin is usually used for this purpose.

Medicines must be injected into the fistulous tract, and also distributed through the tissues near the wound, several times a day. In parallel, methods of physiotherapy can be used, in particular: quartz treatment or UHF therapy.

Surgical intervention

To eliminate the ligature fistula, doctors usually perform a classic intervention, which consists of several stages:

• The surgical field is treated with an antiseptic (usually iodine tincture is used).
• Anesthetize the problem area with injections of Lidocaine or Novocaine.
• A special dye is introduced into the fistula for a complete examination.
• The formed fistula is dissected and the suture material is removed.
• Carry out an audit of adjacent tissues.
• Stop bleeding with electrocoagulation or peroxide.
• Carry out a thorough sanitation of the wound with the use of antiseptics.
• The wound is closed with sutures and active drainage is established.

Competent operation with full sanitation of the wound avoids serious complications. Expectant tactics in the case of a ligature fistula are completely unjustified.

Forecast

In most cases, with the formation of a ligature fistula, the prognosis is favorable for the patient's life and relatively favorable for his recovery. As a rule, such a complication ends in a successful cure, although it may require repeated surgical intervention.

However, in about 60-65% of cases, doctors manage to remove the suture material without surgery. But even in this case, the ligature fistula can recur.

Prevention

The main measures for the prevention of ligature fistula are:

• Competent and careful organization of sterility during surgical interventions.
• Proper preparation of suture material.
• The use of the suture material, which rarely causes complications.
• Performing adequate antibiotic therapy after the intervention of surgeons.
• Compliance by patients with all the recommendations of the doctor and timely visits to the hospital for examinations after surgery.

Doctors assure that there are no 100% effective methods for preventing the appearance of ligature fistulas, because even with absolute sterility there is a risk of infectious agents entering the surgical wound. And it is completely impossible to predict and prevent the possible rejection of the suture material.