Clinical Study On The Management Of Wounds After High Complex Anal Fistula Operation By Sucking-irrigation Dynamic Balance Method Of Traditional Chinese Medicine

Objective:By comparing the quality and velocity of granulation formation and microvessel density on wounds,to observe the clinical effect of the sucking-irrigation dynamic balance method of traditional Chinese medicine in the management of wounds.To explore a new method of more comfortable and effective management for deep wounds after high complex anal fistula operation.Methods:From February 2019 to December 2019,a total of 50 patients with high complex anal fistula according to the inclusion criteria were randomly divided into two groups:the sucking-irrigation dynamic balance method of traditional Chinese medicine management group(Test group)and vaseline gauze conventional dressing group(Control group),25 cases in each group.Observe and record the exudation,granulation color,granulation density,VAS,microvessel density,reduction rate of wound depth,total effective rate and recurrent rate between the two groups.Results:(1)There was no significant difference in age,gender,duration,exudation of wound and VAS on the first day after operation in the two groups(P>0.05);(2)On the fifth day after operation,the exudation of wound in test group was obviously less than in control group,and there was significant difference between the two groups(P<0.01).After removing the negative pressure wound therapy device,The granulation in test group looks red,compact,healthier and without obvious edema.Except for the eschar coursed by electrotome,the rest of wounds were not covered by necrotic tissue、pus mosses and edematous granulation.As there was no dressing pain in 5 days,there was also a significant difference in VAS between two groups(P<0.01).A small amount of wound tissues from two groups were collected for CD31 immunohistochemical analysis.The results showed that microvessel density of the test group was significantly higher than that of the control group(P<0.05).(3)On the 10th day after operation,the patients in test group had removed the negative pressure wound therapy device,separated from the negative pressure condition and changed to the routine dressing therapy,the wound was stimulated by external microorganism infection and inflammation again,the exudation of wound was increased than before,but still had a statistically significant difference compared with control group at the corresponding period(P<0.05).(4)In the course of continuous wound dressing,necrotic tissue gradually dissolved,new granulation gradually grew,the color and density of granulation in two groups were improved,the depth of the wound was reduced.On the 21st and 28th day after operation,the quality and velocity of granulation growth in test group were better than in control group.(5)Because of the influence of the surgical method,the cure rate in two groups were equal and two dressing methods both had significant effect for patients.Conclusion:the sucking-irrigation balance method of traditional Chinese medicine management for wound is a comfortable and effective,Chinese and Western integrative therapy,which can reduce the loss of tissue fluid,ensure the growth quality of granulation,accelerate wound healing,reduce the pain of patients and the workload of doctors.