A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy

Objective: Human amniotic membrane (HAM) used as a wound coverage for more than a century. The aim of this study is to evaluate the efficacy of amniotic membrane on wound healing and reduce post-operative complication. Study design: Randomized clinical trial study. Place and duration of study: Surge...

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Main Authors: Ghahramani Leila, Pirayeh Saeideh, Khazraei Hajar, Bagher pour Ali, Hosseini Seyed Vahid, Noorafshan Ali, Safarpour Ali Reza, Mousavi Laleh
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2017-07-01
Series:Journal of Coloproctology
Online Access:http://www.sciencedirect.com/science/article/pii/S223793631730045X
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language English
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author Ghahramani Leila
Pirayeh Saeideh
Khazraei Hajar
Bagher pour Ali
Hosseini Seyed Vahid
Noorafshan Ali
Safarpour Ali Reza
Mousavi Laleh
spellingShingle Ghahramani Leila
Pirayeh Saeideh
Khazraei Hajar
Bagher pour Ali
Hosseini Seyed Vahid
Noorafshan Ali
Safarpour Ali Reza
Mousavi Laleh
A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
Journal of Coloproctology
author_facet Ghahramani Leila
Pirayeh Saeideh
Khazraei Hajar
Bagher pour Ali
Hosseini Seyed Vahid
Noorafshan Ali
Safarpour Ali Reza
Mousavi Laleh
author_sort Ghahramani Leila
title A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
title_short A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
title_full A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
title_fullStr A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
title_full_unstemmed A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
title_sort randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomy
publisher Thieme Revinter Publicações Ltda.
series Journal of Coloproctology
issn 2237-9363
publishDate 2017-07-01
description Objective: Human amniotic membrane (HAM) used as a wound coverage for more than a century. The aim of this study is to evaluate the efficacy of amniotic membrane on wound healing and reduce post-operative complication. Study design: Randomized clinical trial study. Place and duration of study: Surgery Department, Shahid Faghihi Hospital, Shiraz, in the period of between Sep. 2014 and Nov. 2015. Methodology: 73 patients with anal fistula were divided into two groups. The patients suffered from simple perianal fistula (low type) without any past medical history. Fistulotomy were performed for all of them and in interventional group HAM were applied as biologic dressing. Their wound healing improvement was evaluated post-operative in two groups. Results: From 73 patients participated in the study, 36 patients were in control group and 37 patients were in intervention group. According to the analysis of images taken from the wound, the rate of wound healing was 67.39% in intervention group and 54.51% in control group (p < 0.001). Discharge, pain, itching and stool incontinency was lower in intervention group. Analysis of pathology samples taken from the wound showed no differences between two groups. Conclusion: HAM application could lead to improvement of wound healing and reduced post-operative complications. In conclusion, HAM may act as a biologic dressing in the patients with anal fistula. Resumo: Objetivo: Membrana amniótica humana (MAH) tem sido usada para cobrir feridas por mais de um século. O objetivo deste estudo é avaliar a eficácia da membrana amniótica na cicatrização de feridas e reduzir complicações pós-operatórias. Desenho do estudo: Ensaio clínico randomizado. Local e duração do estudo: Departamento de Cirurgia, Shahid Faghihi Hospital, Shiraz, Irã, entre setembro de 2014 a novembro de 2015. Método: 73 pacientes com fístula anal foram divididos em dois grupos. Os pacientes sofriam de fístula perianal simples (tipo baixo) sem histórico médico prévio. A fistulotomia foi realizada em todos eles e no grupo intervenção, MAH foi aplicada como curativo biológico. A melhora da cicatrização foi avaliada no período pós-operatório em dois grupos. Resultados: De 73 pacientes que participaram do estudo, 36 pacientes eram do grupo controle e 37 pacientes do grupo intervenção. De acordo com a análise das imagens da ferida, a taxa de cicatrização foi 67,39% no grupo intervenção e 54,51% no grupo controle (p < 0,001). Secreção, dor, prurido e incontinência fecal foi menor no grupo intervenção. A análise das amostras patológicas retiradas da ferida não mostrou diferenças entre os dois grupos. Conclusão: A aplicação de MAH pode levar à melhoria da cicatrização de feridas e reduzir as complicações pós-operatórias. Em conclusão, a MAH pode atuar como um curativo biológico nos pacientes com fístula anal. Keywords: Anal fistula, Human amniotic membrane, Wound healing, Post-operative complication, Palavras-chave: Fístula anal, Membrana amniótica humana, Cicatrização da ferida, Complicação pós-operatória
url http://www.sciencedirect.com/science/article/pii/S223793631730045X
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spelling doaj-b90df8a92f064e7e9499e13adde276992021-07-02T08:49:04ZengThieme Revinter Publicações Ltda.Journal of Coloproctology2237-93632017-07-01373187192A randomized trial study on the effect of amniotic membrane graft on wound healing process after anal fistulotomyGhahramani Leila0Pirayeh Saeideh1Khazraei Hajar2Bagher pour Ali3Hosseini Seyed Vahid4Noorafshan Ali5Safarpour Ali Reza6Mousavi Laleh7Shiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranShiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranShiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranShiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranShiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranShiraz University of Medical Sciences, Anatomy Department, Stereology Research Center, Shiraz, IranShiraz University of Medical Sciences, Gasteroentrohepatology Research Center, Shiraz, Iran; Corresponding author.Shiraz University of Medical Sciences, Colorectal Research Center, Shiraz, IranObjective: Human amniotic membrane (HAM) used as a wound coverage for more than a century. The aim of this study is to evaluate the efficacy of amniotic membrane on wound healing and reduce post-operative complication. Study design: Randomized clinical trial study. Place and duration of study: Surgery Department, Shahid Faghihi Hospital, Shiraz, in the period of between Sep. 2014 and Nov. 2015. Methodology: 73 patients with anal fistula were divided into two groups. The patients suffered from simple perianal fistula (low type) without any past medical history. Fistulotomy were performed for all of them and in interventional group HAM were applied as biologic dressing. Their wound healing improvement was evaluated post-operative in two groups. Results: From 73 patients participated in the study, 36 patients were in control group and 37 patients were in intervention group. According to the analysis of images taken from the wound, the rate of wound healing was 67.39% in intervention group and 54.51% in control group (p < 0.001). Discharge, pain, itching and stool incontinency was lower in intervention group. Analysis of pathology samples taken from the wound showed no differences between two groups. Conclusion: HAM application could lead to improvement of wound healing and reduced post-operative complications. In conclusion, HAM may act as a biologic dressing in the patients with anal fistula. Resumo: Objetivo: Membrana amniótica humana (MAH) tem sido usada para cobrir feridas por mais de um século. O objetivo deste estudo é avaliar a eficácia da membrana amniótica na cicatrização de feridas e reduzir complicações pós-operatórias. Desenho do estudo: Ensaio clínico randomizado. Local e duração do estudo: Departamento de Cirurgia, Shahid Faghihi Hospital, Shiraz, Irã, entre setembro de 2014 a novembro de 2015. Método: 73 pacientes com fístula anal foram divididos em dois grupos. Os pacientes sofriam de fístula perianal simples (tipo baixo) sem histórico médico prévio. A fistulotomia foi realizada em todos eles e no grupo intervenção, MAH foi aplicada como curativo biológico. A melhora da cicatrização foi avaliada no período pós-operatório em dois grupos. Resultados: De 73 pacientes que participaram do estudo, 36 pacientes eram do grupo controle e 37 pacientes do grupo intervenção. De acordo com a análise das imagens da ferida, a taxa de cicatrização foi 67,39% no grupo intervenção e 54,51% no grupo controle (p < 0,001). Secreção, dor, prurido e incontinência fecal foi menor no grupo intervenção. A análise das amostras patológicas retiradas da ferida não mostrou diferenças entre os dois grupos. Conclusão: A aplicação de MAH pode levar à melhoria da cicatrização de feridas e reduzir as complicações pós-operatórias. Em conclusão, a MAH pode atuar como um curativo biológico nos pacientes com fístula anal. Keywords: Anal fistula, Human amniotic membrane, Wound healing, Post-operative complication, Palavras-chave: Fístula anal, Membrana amniótica humana, Cicatrização da ferida, Complicação pós-operatóriahttp://www.sciencedirect.com/science/article/pii/S223793631730045X