Effect of Phenytoin Cream on Wound Healing After Anal Fissure Surgery; a Randomized Controlled Trail.

Introduction Anal fissure is defined as an elliptical or longitudinal tear in the anoderm distal to the dentate line, exactly proximal to or at the level of the anal verge . It is one of the most painful anal disorders that inversely affect the life quality of the patients .

Acute anal fissure is a simple rupture in the anoderm existing for less than two months and it is associated with anal pain, spasm, and/or bleeding with defecation. Chronic anal fissure is present for more than six weeks and it is characterized by exposed fibers of internal anal sphincters at the base, hypertrophied anal papilla proximally, and a skin tag or sentinel pile .

Conservative methods are likely to fail and have a higher failure rate with chronically recurring anal fissures. In these situations, the gold standard is the internal sphincterotomy. This surgical procedure treats chronic fissure by preventing hypertonia of the internal sphincter .

Wound healing is an essential step during the procedure of post-operative care after anal surgery . For example, it is believed that a desirable wound healing could help reduce the post-operative pain after hemorrhoidectomy, which quite commonly causes delayed patient discharge .

However, due to the unusual circumstance, the wound healing after anal surgery is frequently delayed by postoperative complications, such as bleeding, infection and edema, despite the use of wound healing creams . Therefore, it is still necessary to investigate more efficient therapeutic regimen to accelerate the postoperative wound healing after anal surgery.