Wound Care

• A piece of absorbable hemostatic gauze will be placed inside the anus after surgery. It will pass naturally with your first bowel movement. Do not attempt to remove it.
• The outer gauze dressing is applied to compress the wound and control bleeding. It may be removed by yourself 3 hours after surgery.
• For conventional hemorrhoidectomy:
• Within 14 days after surgery, clean the area and soak the wound in warm water (sitz bath) for 3–5 minutes, 2–4 times daily. This helps keep the wound clean and relieve discomfort. Use plain water only; do not add any medications or antiseptics.
• For laser hemorrhoid ablation:
• During the first 3 days after surgery, rinse the lower back with cold water for at least 1 minute, 3–4 times daily. Allow the cold water to flow over the anal wound to effectively reduce swelling and pain.
• From postoperative days 4–14, clean the area and soak the wound in warm water (sitz bath) for 3–5 minutes, 2–4 times daily. Use plain water only; do not add any medications or antiseptics.
• After each warm sitz bath, gently dry the anus and apply antibiotic ointment (Spersin). Squeeze out an amount approximately the size of a peanut and use your index finger to apply it about one finger-joint depth into the anal wound.
• After applying the ointment, cover the area with a panty liner, loose gauze, sanitary pad, or foam wound dressing to absorb discharge. Change the dressing after each bowel movement.

Defecation After Surgery

1. Avoid sitting on the toilet for more than 15 minutes to prevent wound swelling and bleeding.
2. After defecation, avoid wiping the wound directly with toilet paper. Rinse gently with warm water only. No povidone-iodine is necessary.
3. It is recommended not to have more than 3 times defecation per day, to prevent wound swelling. Stool softeners will be provided upon discharge; adjust the dosage according to your bowel pattern. (If antibiotics or stool softeners cause diarrhea more than three times per day, discontinue the medication.)
4. You may try consuming coffee, milk, yogurt, olive oil, and increase dietary fiber intake to promote bowel movements.
5. If you have difficulty passing stool, try a warm sitz bath first to relax the anal sphincter, or attempt to pass stool while soaking in warm water.

Lifestyle Adjustments

1. You may generally return to work 3 days after discharge. However, if your job involves heavy physical labor, one week of rest is recommended.
2. Complete wound healing typically requires 2–6 weeks, depending on the severity of the condition and the surgical method used.
3. Within 2 weeks after surgery, avoid deep squatting, heavy lifting (over 10 kg), strenuous exercise (running, ball sports, swimming, yoga, cycling, etc.), and long-distance travel.

Possible Postoperative Anal Discomfort and Management

1. Pain (90%) → Take prescribed anti-inflammatory pain medications on schedule and increase warm sitz baths.
2. Anal swelling sensation (70%) → Take Daflon as prescribed and increase warm sitz baths.
3. Discharge containing blood clots or blood streaks (50%)→ Change wound dressings as needed. This usually resolves within one week.
4. Difficulty urinating (10%) → Take pain medication and try urinating during a warm sitz bath.
5. Pain from granulation tissue or hyperplastic tissue at the wound (5%) → Warm sitz baths with ointment massage, or surgical debridement if necessary.

Discharge and Follow-up Schedule

1. Minimally invasive laser ablation: Discharge is possible 4 hours after surgery.
2. Conventional hemorrhoidectomy: Discharge is recommended the following day.
3. Follow-up visits are required at 1 week and 3 weeks after surgery to assess wound healing.
4. Sutures are generally absorbable and do not require removal. They are typically absorbed within approximately 3 weeks.

When to Seek Immediate Medical Attention(Please return primarily to the Colorectal Surgery Clinic. Seeing a different physician is acceptable.)

1. Wound bleeding exceeding approximately one rice bowl (about 150 mL), accompanied by three or more episodes of significant bloody stool.
2. Fever over 38°C, or acute severe perianal redness, swelling, and pain preventing prolonged sitting, lasting more than 8 hours.
3. Difficulty urinating, lower abdominal distension and pain, inability to urinate for more than 8 hours, or severe difficulty with bowel movements.
4. It is recommended to seek urgent consultation before returning for follow-up. During clinic hours, please call the main line at 04-22052121 and ask to be transferred to the Colorectal Surgery Clinic, or contact your colorectal surgery nurse specialist.