The Use of Dioxisolum Solution in the Comprehensive Treatment of Chronic Anal Fissure

I.М. Kozlovska

Abstract


Introduction. Anal fissures are one of the most prevalent diseases in coloproctology. The problem of surgical treatment of anal fissures is often caused by frequent postoperative complications and relapses, its wide spread, long period of treatment and its social-economical importance. The treatment of chronic anal fissures should be directed in the main pathogenetic links of their development. Therefore a new method of a comprehensive treatment of this pathology is suggested using etiopathogenetically substantiated pharmaceutical agent ensuring stable chemical sphincterotomy and influencing upon the main pathogenetic mechanisms of anal fissures development.
Objective. to improve the efficacy of treatment of chronic anal fissures by means of elaboration and introduction into practical work the methods of treatment based on pathogenetic aspects of the given pathology; to conduct a comparative evaluation of treatment by traditional methods and suggested by us a comprehensive method of treatment of chronic anal fissures.
Material and Methods. The article presents the results of treatment of 44 patients with chronic anal fissures. All the patients were divided into two groups: the main group (22 individuals) included the patients receiving interstitial electrophoresis with dioxisolum®-Darnitsa solution, and the control group (22 individuals) received generally accepted methods of treatment of anal fissures. All the patients were observed during 3 months after hospital treatment. A combined action of interstitial electrophoresis and etiopathogenetically substantiated medicine — dioxisolum®-Darnitsa solution (Darnitsa pharmaceutical company, Ukraine) was used in the main group of patients. Electrophoresis was conducted by means of the device «Potok-1» with electric power of 0.01–0.05 mA/cm2 during 60 minutes.
Results and Discussion. Marginal epithelization of chronic anal fissure was observed already on the 8.95 ± 0.34 day of galvanization with dioxisolum®-Darnitsa solution, and only on the 14.05 ± 0.43 day against the ground of traditional methods of treatment of chronic anal fissures. Healing of anal fissures in the patients from the main group was 2.5 times quicker (on the 14.05 ± 0.43 day) in comparison with the control group (on the 34.41 ± 1.02 day) (P < 0.001). The use of electrophoresis with dioxisolum®-Darnitsa in a comprehensive treatment of anal fissures has resulted in quick and considerable elimination of pain syndrome (6 points lower during 10 sessions) without any side effects of the drug.
Treatment time in applying our proposed treatment of chronic anal fissure was 10.09 ± 0.71 day because patients underwent 10 sessions of interstitial electrophoresis with dioxisolum®-Darnitsa solution and duration of treatment in the control group, which used to treat calcium channel blockers and donors NO (nitrates) for 5–8 weeks — 47.07 ± 0.75 day, in 4.7 times longer compared to the main group.
Conclusions. Application of the algorithm of treatment of chronic anal fissures worked out by us leads to the improvement of conservative therapy of chronic anal fissures on 35 %, reduces the period of treatment in 4.7 times and accelerates the healing process in 2.6 times. The suggested comprehensive treatment of anal fissures speeds epithelization and terms of healing of anodermal defects, and eliminates spasm and pain of the anal sphincter quickly breaking the main pathogenetic mechanism of development of this disease. The proposed algorithm is technically simple, it does not have any contraindications and is available for use in hospitals and out-patient departments.


Keywords


anal fissure; interstitial electrophoresis; dioxisolum®-Darnitsa solution; fissure epithelization; pain syndrome; side effect

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DOI: https://doi.org/10.22141/1997-2938.2.25.2014.83083

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