| Objective:By observing the clinical efficacy of the vacuum assisted healing(VAC)treatment system combined with Cayratia Japonica Cream in the management of high-complexity anal fistula postoperative wounds,we can strive to find a new way with reliable curative effect and less pain to manage the postoperative wound of high-complexity anal fistula.Methods:A total of 72 high-complicity anal fistula patients meeting the inclusion criteria were admitted to the National Anorectal Center of the Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2016 to February 2018.They were randomly divided into vacuum assisted healing(VAC)treatment system combined with Cayratia Japonica Cream group(experimental group)and the Vaseline oil gauze group dressing by traditional methods(control group),each group 36 people.Results:(1)There was no significant difference in age,gender,and wound area on the second day after operation between the two groups(P>0.05);(2)When the two groups were followed up for 2 months,the total effective rates of the experimental group and the control group were 94.44%and 77.88%,respectively,and the total effective rate of the experimental group was higher than that of the control group.The difference was statistically significant(P<0.05);(3)Wound area was evaluated on the second day after operation for baseline assessment.On the seventh day after operation,the area of wounds and area reduction ratio of the two groups had no statistically significant difference(P>0.05);Postoperative days 10 and 15 On days,the wound area of the experimental group was significantly smaller than that of the control group.The reduction rate of the wound area in the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05);(4)The activities of active MMP-2(72KD)and active MMP-9(92 KD)in the wound fluid samples from both groups began to increase on the first day after treatment,peaked on the third day after treatment,and then gradually decreased on days 5,10,and 15.It indicated that the activity of active MMP-2 and active MMP-9 in the wounds of each group was not linearly increased during the treatment.Before treatment,the activity of active MMP-2 and active MMP-9 in the experimental group was not significantly different from that in the control group(P>0.05).On the 3rd,5th,10th,and 15th days after treatment,the activity of active MMP-2 and active MMP-9 in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).It indicated that the activity of active MMP-2 and active MMP-9 in the experimental group was higher on the third day after treatment than in the control group.On the 5th,10th,and 15th days after treatment,the decrease of the activity of the active MMP-2 and active MMP-9 in the experimental group was smaller than that of the control group;(5)On the second postoperative day,there was no statistically significant difference between the granulation tissue growth index scores of the experimental group and the control group(P>0.05);On the 7th,10th and 15th days after operation,the scores of granulation tissue growth in the experimental group were significantly better than those in the control group,and the difference was statistically significant(P<0.05);(6)There was no significant difference in the bacterial detection rate between the two groups before treatment(P=0.586>0.05);On the 10th day after treatment,the bacterial detection rate of wounds in the two groups was compared,and the experimental group was significantly better than the control group.The difference was statistically significant(P=0.000<0.05);(7)On the seventh,fifteenth day after operation,the pain scores of the two groups were compared,and the pain level of the experimental group was significantly lower than that of the control group.The difference was statistically significant(P<0.05);(8)After follow-up for six months,the recurrence rates in the two groups were 8.33%in the experimental group(recurrence in 3 cases)and 22.22%in the control group(8 relapses).The difference was statistically significant(P<0.05).Conclusion:Vacuum assisted healing(VAC)treatment system combined with Cayratia Japonica Cream as a combined treatment of traditional Chinese medicine and Western medicine,applied to high complex anal fistula postoperative wound,not only can significantly promote wound healing,reduce postoperative wound pain,reduce the recurrence rate,and can add fast bed turnover,save social resources,worth clinical application. |
PDF Full Text Request