Clinical Research On The Postoperative Wound Healing Of High Posterior Horseshoe Fistula By The Method Of Scratching And Eliminating Slough

Objective:To observe the clinical efficacy of the method of scratching and eliminating slough to the postoperative wound healing of high posterior horseshoe fistula.Methods:Between July2011and November2013,42patients underwent posterior horseshoe anal fistulas were treated at the Nanjing hospital of T.C.M and were included in the present prospective study,and randomly divided into the treatment group (21case as scratching and eliminating slough) and the control group (21case as Conventional therapy). To compare the wound areas, wound vertical diameter, wound granulation tissue and wound secretion of two groups patients in the seventh day, fourteenth day, twenty-first and thirty-fifth day after operation and the wound healing time, the total therapeutic effect after the6th weeks.Results:(1) After6weeks, complete wound healing was achieved in21patients (95.24%) in the treatment group and21patients (71.43%) in the control group (P=.009);(2) There was no difference in the wound area and wound vertical diameter of the seventh day between the two groups(P>0.05). However, there were significant differences between two groups in the wound area and wound vertical diameter of the14th/21th/35th day after surgery(all P>0.05);(3)wound healing time was significantly more in the two groups (53.48±8.31vs.71.89±13.69)(P<0.05);(4)granulation coverage of the wound was significantly greater with scratching than with no scratching at the14th/21/35th day after operation (P<0.05),then there was no difference at the7th day between the two groups(P>0.05);(5)wound secretion was reduced in patients who received scratching than in those who received conventional therapy at the14th and21th day after operation(P<0.05),then there was no difference of the7th and14th day between the two groups(P>0.05);(6)At a follow-up of3months the recurrence rates were4.3%(n=1) in the treatment group and26.3%(n=5) in the control group, which was not significantly different(P>0.05), wound scar area was significantly more in the two groups (1.73±0.46cm2vs.2.35+0.43cm2)(P<0.05).Conclusion:The results of this study add support to the evidence that the high post-erior horseshoe fistula’s postoperative wound would generate much "slough", scratching and eliminating slough is an ideal treatment to meet the demand of clinical; the postope-rative wound repair process has certain time limitation, this method could breakthrough the time limitation of wound repair after operation, the growth of the granulation can orderly towards clinicians expected growth, accelerate wound healing; This way can clear the w-ound epithelial organization in time, making the basal wound keeping advantage growth, Maintaining of the anatomy of the anal canal circular structure integrity, reducing malfor mations, but this conclusion still need further study.