COMPARING RADIAL AND CIRCUMFERENTIAL SKIN INCISIONS IN OPEN LATERAL INTERNAL SPHINCTEROTOMY FOR CHRONIC ANAL FISSURES: WOUND HEALING AND COMPLICATION RATES

Abstract

Background: The safest and most effective surgery for chronic anal fissures (CAF) is lateral internal sphincetrotomy. Chronic anal fissures that have not responded to conservative or medical treatment are often treated with it. Even with this minor surgery, problems can occur. LIS usually requires an intersphincteric incision. Clinical prognosis and wound healing may differ between techniques, although it's unclear. We compared wound healing and other clinical outcomes in LIS patients with radial and circumferential incisions. OBJECTIVES: To compare radial versus circumferential skin incisions in open lateral internal sphincetrotomy among patients with chronic anal fissures in terms of wound healing and complications. MATERIALS AND METHODS: A As to operational definitions, 60 patients aged 20–60 with chronic anal fissures had surgery. Both genders were included. Inflammatory bowel illness, diabetes, immunosuppressive medication, previous perianal surgery, AIDS, any immunocompromised condition, and steroids were excluded from the study. Competent surgeons performed LIS on 30 patients per group by the open method. Group A had radial incisions, while Group B received circumferential incisions. Postoperative complications such as fistulas, abscesses, wound healing time, and cellulitis were monitored. RESULTS: 30 patients were treated with radial incisions, while the remaining 30 received circumferential incisions. In the group who were treated with circumferential incisions, the wound healing time was less comparative to the radial incision group (19.1 vs. 24.0 days, p 0.001). However, in other variables like cellulitis, perianal fistula, and abscess, the difference was insignificant. Conclusions: Our study shows that circumferential skin incisions during LIS are associated with shorter healing times than radial incisions.