Topical tannic acid application decreases posthemorrhoidectomy pain: a novel idea

Abstract

Background Posthemorrhoidectomy pain represents an annoying problem for the surgeon and the patient; although it can be controlled with an analgesic ladder, its management remains in question. Purposes The current study investigated the efficacy of topical tannic acid powder in reducing postoperative pain, in promoting wound healing after open diathermy hemorrhoidectomy, and in the prevention of secondary hemorrhage. Patients and methods A prospective, randomized trial was conducted on 97 patients suffering from grade 3 or 4 internal or external hemorrhoidal disease to compare posthemorrhoidectomy pain and wound healing with the use of topical tannic acid applied to the surgical site compared with placebo. Postoperative follow-up was for 3 months. Results Postoperative pain in patients given topical tannic acid improved during the first 2 days (VAS: 1.2 ± 0.4 vs. 8.2 ± 0.6; P 0.05). In addition, secondary hemorrhage in the topical tannic acid group was significantly less (mean score, 2.0 vs. 12.0; P Conclusion Topical tannic acid application plays an important role in diminishing postoperative pain, in improving wound healing after open diathermy hemorrhoidectomy, and in preventing secondary hemorrhage.