Fistula Treatment with Setons
A seton is made of rubber or string-like
material. It is used to treat a fistula. It can
be used alone, combined with a fistulotomy,
or used in a staged fashion (first
this…then…). Setons promote healing of
the fistula tract by keeping it open. This
allows it to drain and heal from the inside
out. This may be needed before doing a
final surgery to fix the fistula. At which
time, the seton is removed. Second, they
can also be used to slowly move through a
fistula when the anal sphincter muscle is
involved. The slow healing creates a scar,
closing the tract as it heals, from the inside
out. A seton may be changed every 4-6
weeks in outpatient surgery. It can take 4 or
more changes before the tract is healed.
Some people have setons for 6 months or
longer. There is no time limit to keep the
tract open and avoid future abscess,
especially in the case of crohns disease.
Getting Ready for Surgery
If you smoke, you need to quit. Smoking
delays wound healing. We can help you
You may need to do bowel prep before
surgery. We will discuss the details with
Expect drainage until the fistula heals. You
will want to wear pads to manage and check
the drainage. The drainage can cause a skin
rash. You may need to use a special cream
to protect your skin before you have a skin
problem. You may want to try A & D®
Ointment, Aquaphor®, or Sensicare®. Apply
cream to dry skin so you do not trap
moisture under the ointment that can cause
more skin problems.
Sitz baths 3-4 times a day will help keep the
area clean and may help with the pain.
Apply the ointment after these soaks.
Pain varies from person to person. Your
doctor will order pain pills for you.
Please follow the guidelines we will give to
you the day of the surgery. They may
Plan to take off work a few days to a
Have someone to help watch your
children for 1-2 days.
Wear loose clothes.
Avoid sitting or standing for periods
of more than 1 hour.
You may have to limit lifting to no
more than 20 pounds.
Avoid all tobacco including second
Pain pills can cause constipation. You will
want to use a stool softener (docusate
sodium) to prevent this problem up to 4
tablets per day. Drinking enough fluids will
also help to prevent constipation. You may
also need to use a laxative. You can buy
these over the counter at your local
drugstore. Follow the package directions.
When to Call the Doctor
Problems with bowel movements.
Temperature by mouth over 100.4 θF
for two readings taken four hours
Pain not relieved by pain pills.
Bleeding that does not stop after 10
minutes of applied pressure to the
Digestive Health Center: (608) 890-5000.
After hours, weekends or holidays this
number will be answered by the paging
operator. Ask for the doctor on call or ask
Leave your name and phone number with
area code. The doctor will call you back.
If you live out of the area, call: (855) 342-
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 11/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7123