A comparative study of wound opening versus primary closure after fistulectomy in the lower anal fistula

Abstract

Objectives. The aim of the study is to investigate the outcome of primary wound closure versus non-wound closure after fistulectomy in terms of postoperative pain and wound healing time. Materials and Methods. A prospective comparative randomized study was performed on patients admitted to the General Surgery Department of our Institute (Dec.1, 2019-Nov.31, 2021), with a diagnosis of low anal fistula and undergoing fistulectomy. 54 patients were included in the study and were assigned alternately and equally in group A (fistulectomy with laying open of wound) and group B (fistulectomy with primary closure), with 27 patients in each group. On day 1 postoperatively, the pain score was assessed by analog visual scale. Patients were followed for 6 weeks, and healing was assessed by visual examination of epithelialization at each follow-up visit. Results. In our study, the average healing time in group A was 20.77 days and in group B 14.07 days (the average healing time in group B is significantly longer than in group A, with P value of <0.00001). In our study, the average pain score among the participants in group A is 4, and among the participants in group B it is 2,148, with the value P <0.00001, which is statistically significant. Conclusion. Primary closure fistulectomy is a better method for treating low anal fistula due to the fact that it causes less pain, accelerated healing compared to wound opening fistulectomy. However, further studies are needed to compare other methods of treating low anal fistula.

Keywords

• fistulectomy
• primary closure
• wound healing
• pain score
• recurrence