Topical Tannic Acid Application Decreases Posthemorrhoidectomy Pain: A novel Idea
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BACKGROUND:Posthemorrhoidectomy pain represents annoying problem for the surgeon & the patient; despite Its control can be done by analgesic ladder; it remains in question. Purposes: The current study investigated the efficacy of topical tannic acid powder in reducing postoperative pain, promoting wound healing after open diathermy hemorrhoidectomy and prevention of secondary hemorrhage. Patients and methods: A prospective, randomized trial was conducted to ninety-seven patients suffering from grade 3 or 4 internal or external hemorrhoidal disease; to compare posthemorrhoidectomy pain & wound healing with the use of topical tannic acid applied to the surgical site. vs. placebo carrier. Postoperative follow up was for 3 months. Results:Topical tannic acid patients improved postoperative pain at lg 2 days (VAS: 1.2 ± 0.4 vs. 8.2 ± 0.6; P <0.05) and 7th day (VAS:, 3.6 ± 0.6 vs. 6.3 ± 0.5; P <0.05) & improved wound healing significantly (Postoperative edema: (mean score, 3.0 vs. 7.0; P <0.05) & Overall wound healing: (mean score, 4.0 vs. 6.0; P <0.05)) despite there was no difference as regard Primary vs. secondary healing (P >0.05). Also secondary hemorrhage in the topical tannic acid group was significantly less (mean score, 2.0 vs12.0; P <0.05).