Giannini I, Pecorella G, Pennisi D, Santangelo G, Digennaro R, Latorre F, Giuliani G, Altomare D F
Department of Emergency and Organ Transplantation University of Bari, Bari, Italy -
Minerva Chir. 2014 Apr;69(2):75-82.
Milligan-Morgan hemorrhoidectomy (MM) is still the most common treatment for grades III and IV hemorrhoids despite prolonged post-operative anal pain and wound healing. This multicenter, double blind, randomized, controlled trial was designed to assess the safety and the efficacy of anal wound cleansing with Triclosan (Proctocid®) in the control of symptoms and healing time after MM.
A total of 113 patients with grades III and IV hemorrhoids, undergoing open hemorroidectomy by diathermy or Ligasure vessel sealing device, were randomly assigned to Triclosan or sodium hypochlorite solution. All patients received analgesics and a fiber-rich diet after hemorrhoidectomy. Postoperative anal pain, bleeding and/or secretion and itch were assessed 7, 14 and 21 days after hemorrhoidectomy by a Visual Analogue Scale (VAS) and the day of complete re-epithelialization of anal wounds was recorded.
Fifty-five patients were randomized for Triclosan treatment and 58 for the control drug. The two groups were comparable for demographics, severity of hemorrhoids and technique used for the hemorrhoidectomy. The comparison of days to get complete anal wound healing shows a trend of significance (P=0.05) for the Triclosan group. Bleeding and/or secretion, anal pain and itch were significantly better (P=0.003; P<0.0001 and P=0.01, respectively).
Triclosan solution for the treatment of post-hemorrhoidectomy wounds is safe and improves the control of post-operative symptoms and wound healing time compared to sodium hypochlorite.
尽管米利根 - 摩根痔切除术（MM）术后肛门疼痛持续时间长且伤口愈合慢，但它仍是治疗III度和IV度痔疮最常用的方法。本多中心、双盲、随机对照试验旨在评估用三氯生（Proctocid®）清洁肛门伤口在控制MM术后症状和愈合时间方面的安全性和有效性。
共有113例III度和IV度痔疮患者，通过透热疗法或结扎速血管闭合装置进行开放性痔切除术，被随机分配接受三氯生或次氯酸钠溶液治疗。所有患者在痔切除术后均接受镇痛药和高纤维饮食。在痔切除术后7天、14天和21天，通过视觉模拟量表（VAS）评估术后肛门疼痛、出血和/或分泌物及瘙痒情况，并记录肛门伤口完全重新上皮化的日期。
55例患者被随机分配接受三氯生治疗，58例接受对照药物治疗。两组在人口统计学、痔疮严重程度和痔切除术所用技术方面具有可比性。三氯生组在肛门伤口完全愈合天数的比较上显示出显著趋势（P = 0.05）。出血和/或分泌物、肛门疼痛和瘙痒情况明显更好（分别为P = 0.003；P < 0.0001和P = 0.01）。
与次氯酸钠相比，三氯生溶液用于治疗痔切除术后伤口是安全的，并且能改善对术后症状的控制和伤口愈合时间。
