Efficacy of 0.2% GTN in Reducing Duration of Wound Healing after Fistulectomy

Abstract

OBJECTIVE: To analysis the efficacy of 0.2% GTN in patients undergoing fistulectomy for fistula in ano low variety in terms of early wound healing. METHODOLOGY: A randomized controlled trail was conducted at general surgery department of Liaquat University Hospital Hyderabad from February 2013 to August 2013 among patients with low anal fistula. All participants underwent fistulectomy by a consultant general surgeon. Patients were divided into two groups using lottery methods. Group A treat fistula in ano with 0.2% glyceryl trinitrate ointment and group B treat fistula in ano without 0.2% glyceryl trinitrate ointment and wounds covered with pyodine soaked dressings. All patients were discharged on second postoperative day. Wound healing was assessed weekly for six weeks. Parameters of incomplete wound healing such as discharge, perineal irritation and pain were noted. Presence of granulation tissue at the end of 6 weeks was considered as sign of healing. Data was collected via study proforma. RESULTS: This study was conducted on 94 patients in Liaquat University Hospital Hyderabad. In GTN group 35(74.46%) were male while in Control group 38(80.85%) were male. In GTN group mostly observed single opening 37(78.72%) cases while in control group 35(74.46%) cases. The healing time in GTN Group was found to be between 21-36 days (mean 26.38 days), while the healing time control group was 32-46 days with a mean of 38.64 days (P. value <0.001). The complications were also found significantly higher in the control group CONCLUSION: In conclusion our study revealed that postoperative 0.2% GTN after fistulectomy can be used as a primary treatment of low fistula in ano as a shorter period of time for wound to early heal and the less incidence of complications is comparable to that of control group. Key words: fistula in ano, 0.2% GTN, Effectiveness