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Crohn's Disease / Ulcerative Colitis Community
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Avatar universal

Seton has two strands?

Can anyone shed some light on this for me? I just had surgery to place a seton in a refractory fistula, and it looks like there are actually two setons running through the same tract. I was only expecting to see one suture/string. Is this common, might I have two fistulas close together and the surgeon used two setons...? Anyone familiar with this scenario?
10 Responses
Avatar universal
Hi-I don't really know much about the surgery-maybe the 2 are more effective than 1? I had a perianal abscess drained in my local ER Feb. 09 and I have been living with an open fistula now for 4 months, and it drains constantly. I am on antibiotics, but the inflammation and pain from the fistula is unbearable and I am  brought to tears from the pain. I was diagnosed with Crohn's 2 months ago. My GI Dr. sent me to a colorectal surgeon, and he said surgery would be last resort (seton placed in the fistula), after we try Remicade, which will likely be my next course of treatment (the surgeon said Remicade heals fistula's 80% of the time). I go back in 4 weeks to re-***** the situation. So I can relate to the fistula. Have you found any relief so far since the placement?
Avatar universal
I had this same surgery about 18 months ago. I wouldn't wish it on anyone; but we did the surgery before trying the remicade as the dr thought it could be taken care of surgically without the side effects of the remicade.
My seton was supposed to be in place for 4 days.. which turned into six weeks. So don't be discouraged if it takes a little while to heal.
As for the two strands; the seton is a specific type of stitch used to heal the fistulous tract, It looks a bit like a loop- mine was made from a surgical grade silk and was surprisingly thick. Since the stich is a loop, there are two ends to the loop of the same stitch.
Best of luck- as for the pain... HOT baths, as hot as you can stand them (try getting in the tub and then starting the water, it isn't such a shock this way), worked better than narcotics for me.
Avatar universal
Hi, I am nearly 3 years since the first infection and just had my 7th Fistula op yesterday.
Due to the year long delay with the NHS, I had a massive infection 18 months ago and pretty much had half of my 'cheek' removed; with 2 weeks in hospital and the help of a VAC dressing it healed well - except for the same tiny fistula - 4th op on from that they have placed a seton.
I do not know if this will work.
The surgeon has told me to try and get on with my life as normal as I may not ever heal...."A fistula patient is a patient for life"
I know this may sound depressing but it was the one bit of advice that changed my life!  I was sooo depressed, but after hearing this I was detremined to get back to normal and I feel so good now I have acceped it.
I have been running 20 miles a week and hiking 30-40 miles over weekends,  I also climb regularly, the saddest thing for me is my career was event riding and training horses - I had not ridden for 2 1/2 years but have just started riding again and found as long as the bottom is strapped up and well padded I can bear it!

However: as I now have a seton I am worried about a few things, the fact I was able to continue with sports has kept me going, I am worrid this seton is going to pt a stop to it.  Can anyone help me with these questions?
1; will the strings get in the way and rub when I run?
2; when climbing will it tare through muscles as they extend?
3: my desperate worry, my partner and I have been waiting eagerly for my repair as we want to start a family.  It's just not happening and now I am scared that it is not a good idea to fall pregnant with a seton in...this is something that is becoming quite an obsession and all I can think about as I am 30 now and cannot see an end to this, before the seton I would have gone for it, now I am worried about damaging the muscles.  

Has anyone else had a baby with a seton in place?  I would love to hear from anyone who can help as the surgeons seem to be very tight with any information.
Thanks
Haych
Avatar universal
Thanks to all for your advice and sharing your stories. Since my last post, I have had the second stage surgery-a fistulotomy following seton. My surgeon thinks he "got it all."  Bless him for being so optimistic, but I've heard that before (this was surgery #5 in 16 months). At least I trust this doc more than anyone else; got glowing recommendation from friend who had severe UC and this guy saved her with colectomy and pouch creation staged over about 2 years (he actually pioneered the process a couple of decades ago, so he must be one of the best!).  Anyway, I'm still concerned that the areas near the incision (from 7/1/09) which began to drain purulent discharge 2 weeks after the seton placement are still not completely gone. We'll see, I'm sure the pain then drain cycle will show up soon if it's going to at all.

By the way, any women out there battling with fistula/abscess/drainage find a way to be intimate during this whole scenario? My husband and I are going bananas after 16 months with an open wound. (Actually, it was healed for about 4 weeks this spring, but I had pneumonia at the time, so no luck then either.)  
Avatar universal
Hi guys can anyone help me?

I had to have emergency surgery on a massive abcsess down there.  Now i have got a seton in .  It has only been a week and I go back to the speciaist in 4 weeks.  however around the seton where it comes back out of the abscess my skin has stretched and there is a bit of a hole around where the tube comes out?  Is this normal?  The nurse said it was and i was being over the top ......howver there was NO hole there whe i had the surgery! the tube just came out of the skin and there was a tiny gap aorund it, now that gap is about a CM big!

Can I ask were there stitches holding the seton in place (stitched onto your skin? Or just stitches holding the two ends of the seton together (n the loop bit)  God I hope that makes sense I am freaking out!

Also it is leaking SO much Pus/ yuck stuff on a daily basis.
Apparently this is normal as well!?

It would be so good to hear from someone who has been through this before i am only a 20YO girl, with no idea!  The  surgery was so quick, in,  out and no doctor even gave me follow up prcedures, what I should/shouldnt do and the nurse is always so busy and thinks I'm over reacting :(
Avatar universal
Dear all,
I had one anal abscess surgery and two Fiutula with seton inertion surgeies.Last was 6 weeks ago.Today the  seton was diappeared I assumed fell off itself.I am on waiting list for next surgery. Is anyone tell me is it possible that seton came off itself? Last year my seton was intact all the time.
thank you,
sawan
Avatar universal
Hi there, it depends on what your Dr. said to do with them, leave it be, go in and get them tightened or pull on them yourself.
Avatar universal
I had a surgery to repair a fistula 3 weeks ago doctor put a seton which was there for all this time doctor sed that i needed to keep the seton tight which I did but last night I knowrest the seton was loose and when I check it was out the end that was inside the surger hole had a loop of aproximately 1/4 of an inch my question is the seton rip or it did what it was supost to do as doctor sed cut my mussel and that why is out please anyone that had this problem let me know what's going on with my seton
Avatar universal
I hear that there is some natural medicine that can help to remove or reduce verticulitis enyone know which is this natural medicine
Avatar universal
hi again this is my 30 days since i had a fistolotomy with a seton my seton came of a week ago I went to the surgen las tuesday and he look at me  and sed that everything is going well and recovering I ask him what were the changes of getting a new one he sed dont know there is always the posibility as of today I fell good and helping myself with my conspitation problem that posibilty started this fistula. I drink a mixture of mexican cactus(nopal) alo vera plant (savila) celery (apio) cucamber (pepino)and pineapple this is reallly helping me for constipation
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