Over 8 months after having an abdominoperineal resection as part of the proctosigmoidectomy, I’m back having the entire thing reopened in a bid to try and resolve the wound healing issues.

Apprehension

With past procedures I had a fairly good idea about what would be happening and recovery times but this time was different. I knew that the an opening would need to be made to go in and scoop all the gunk out and create an area that would have a better chance of healing. I was presuming that the surgeon would go in through the existing wound as nothing as mentioned about opening the abdominoperineal resection (aka the Ken Butt).

In the days leading up to the surgery I was a little apprehensive as the surgery could end up being ‘straightforward’ through to quite major and a big step back.

Discovering What Would Be Happening

I met with the surgeon early in the morning in pre-assessment and he outlined what would be happening and it wasn’t going to be ‘straighforward’. Based on the wounds not healing, and not going to heal without intervention, he had made the decision to completely reopen the AP resection and leave it open to heal. I’m all up for doing whatever it takes to ensure that everything heals but it wasn’t what I was hoping for. I’m essentially going right back to the beginning of the process.

I was expecting to come in the Friday, stay over the weekend and leave on Monday either with, or without, a VAC dressing. There would obviously be a potentially long healing time but I was expecting to be ‘back to normal’ and continuing with daily life. Turns out that was not going to be the case. When asked how long the recovery process would be he said I should be able to return to work within a month! A month? And I was to take things easy going forward in order to not interfere with the healing process. This highlighted how big the procedure was going to be.

He wasn’t sure whether the remaining wound would be left open to heal naturally or if a VAC dressing would be used. This would be determined during the surgical procedure.

The Procedure

I was one of the first procedures of the day so no waiting around or bing pushed back due to incoming emergency procedures. I went through the usual pre-op procedures and prepping for the anaesthetic but something new was introduced this time with a weird monitoring strip that was stuck to your forehead.

The procedure was relatively quick and in no time at all I was in recovery and being visited by the surgeon. The long term question of whether the perineal wound and pilonidal sinus were connected was finally answered. Yes, they were. I don’t think the recent MRI picked this up but the fact that they were connected meant that the only real way of addressing it would have been to open up the Ken Butt so it was definitely something that needed doing.

I left the theatre without a VAC dressing but one will be fitted on Monday. Haven’t never experienced one before, or even seen one, it’s going to be a challenge. Not sure how much of a challenge it will be to sit down, how big the device will be or if it makes a noise.

As soon as it’s fitted I’ll post an update.

Have you been here before? You look familiar.

D5 East Nurse
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Diagnosed with IBD in 2002, I have experienced the usual ups and downs of having a chronic disease and tried numerous medications but the time finally came in 2018 to elect to have surgery to improve my life.

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