How long does the wound take to close?

It depends on width and depth; most close over weeks from inside out. Regular dressings help prevent the surface sealing over a residual pocket.

When can I return to work?

Desk work is often possible within days to 1–2 weeks; heavy work and intense sport later. Timing follows wound size and pain.

What is urgent after fistulotomy?

High fever, rising swelling or pain, uncontrolled bleeding, or inability to urinate — seek care without delay.

Conditions/Anal Fistula/Chapter

Detailed chapter

Fistulotomy

Name: Fistulotomy
Creator: Assoc. Prof. Cengiz Dibekoğlu, MD

Laying open a low, simple fistula track — high healing when sphincter risk is low

Fistulotomy opens the tunnel along skin and mucosa into a groove that heals from the inside out. In simple, low fistulas healing rates are often very high (commonly in the 90%+ range in series). In high tracks, cutting too much sphincter raises incontinence risk — so it is not used for every fistula.

Fistulotomy — educational figure — Fistulotomy · educational illustration

Who may be a candidate?

Low intersphincteric or low transsphincteric simple fistulas
A single clear track with abscess pocket controlled
Patients with adequate sphincter reserve

Step-by-step overview

1
Internal and external openings
The track is confirmed with probe and/or dye.
2
Lay-open
Tissue over the tunnel is divided so the track becomes an open wound.
3
Healing
The wound closes by granulation; dressings and hygiene are planned.

Key points

Aftercare essentials
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Sitz baths and dressings, soft stools, and expected staining in the first weeks. Skip follow-up visits at your peril — early wound problems are easier to fix early.
- Sitz baths and wound care
- Keep stools soft
- Staining in early weeks can be normal
- Keep control appointments
Continence and recurrence
Tap for details · key note inside
In carefully selected low fistulas incontinence risk is low. Higher tracks need sphincter-sparing alternatives. Recurrence after simple fistulotomy is relatively uncommon but rises if a side branch is missed or wound care fails.

Frequently asked questions

How long does the wound take to close?
Tap for details
It depends on width and depth; most close over weeks from inside out. Regular dressings help prevent the surface sealing over a residual pocket.
When can I return to work?
Tap for details
Desk work is often possible within days to 1–2 weeks; heavy work and intense sport later. Timing follows wound size and pain.
What is urgent after fistulotomy?
Tap for details
High fever, rising swelling or pain, uncontrolled bleeding, or inability to urinate — seek care without delay.

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Appointment / info

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This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.