MEDICAMENTAL THERAPY IN THE TREATMENT OF POSTOPERATIVE WOUNDS PERINEUM AND ANAL CANAL

Abstract

AIM. Postoperative wounds of the anal canal and perineum, even small in volume, heal long enough. Along with the local treatment of such wounds in some cases, it is effective to prescribe medications for oral administration, in particular venotonic drugs. In the State Scientific Center of Coloproctology from November 2016 to March 2017, a study was conducted to evaluate the efficacy of Venarus for the treatment of postoperative wounds perineum and anal canal METHODS. The study included 113 patients diagnosed with hemorrhoids. In some patients, along with hemorrhoids, there were concomitant diseases - a chronic analfissure or fistulas of the rectum. The main group consisted of 59 people who were treated with Venarus, and 54 people in the control group. The evaluation methods included clinical examination, profilometry, cytological examination of print smears, quality of life of patients on the QoL SF-36 scale before surgery, on discharge and on the 28th day after surgery. In each group, patients were included, homogeneous in terms of key indicators. RESULTS. Patients in the main group needed significantly fewer non-narcotic analgesics after surgery. The pain level in the first 4 days of the patients of the main group against the background of the ongoing therapy with the Venarus drug was significantly lower in comparison with patients receiving only traditional local treatment. The level of reliability was directly dependent on the stage of hemorrhoids - the more the stage of hemorrhoids was, the higher the level of reliability. In patients in the control group, hyperthermia was significantly longer than in the main group - 1.61 ± 0.11 and 1.22± 0.10, respectively (p<0,008). In clinical evaluation of postoperative period, minimal edema in the postoperative wound area or infiltrate after sclerotherapy of internal hemorrhoids was preserved in 81.5 % of patients even on day 28, whereas by this time in all 100 % of patients of the main group of edema in the wound area was not observed. At the cytologic examination, no significant inflammatory infiltration was registered in the patients of the main group already 15 days after the operation, whereas in 50 % of patients in the group only cytological signs of active inflammation (p<0.0001) remained in the group with only local treatment. On day 28, in 100 % of patients in the main group, no signs of inflammation were present, and in 74.1 % of the control group there were still signs of minimal inflammation (p<0.00001), Application ofVenarus ultimately affected the quality of life patients - physical and mental, because a significant reduction in pain, as well as inflammatory wound reaction led to a faster recovery. Especially the differences in the quality of life were manifested on day 28 after the operation (p<0,001).