Topical sucralfate promotes wound healing after hemorrhoidectomy: Study

Topical sucralfate reduced the need for pethidine and diclofenac while also reducing pain and promoting wound healing, says an article published in International Wound Journal.

The anal cushions' symptomatic expansion and distal displacement are known as hemorrhoids, a frequent benign anorectal disease. Depending on the degree and severity of symptoms, treatment options for hemorrhoids can range from dietary and lifestyle changes to open surgery. After a hemorrhoidectomy, pain is still one of the most common complaints from patients. Pethidine is a synthetic opioid analgesic that is frequently used for moderate to severe acute pain, including that experienced during labor, by patients recovering from surgery, and after open hemorrhoidectomy. Diclofenac is a non-steroidal anti-inflammatory medicine (NSAID) that is frequently used to treat mild to moderate pain. When taken frequently, it can cause nausea, vomiting, and renal impairment.

It is frequently administered following an open hemorrhoidectomy and has been administered intravenously, orally, or rectal. Topical sucralfate is frequently used to treat burns and excoriations. It is believed to improve tissue granulation and epidermal development, hence resolving patients' issues. Reno Rudiman and colleagues undertook this trial to assess the feasibility, safety, and superiority of topical sucralfate following hemorrhoidectomy.

In comparison to a placebo, researchers looked at how topical sucralfate affected wound healing rate, pethidine use, and postoperative pain scores (at 24 hours, 7 days, and 14 days). The PRISMA guidelines were followed during the conduct of this investigation.

The key findings of this study were as follow:

1. The remaining six trials involving 439 individuals who had hemorrhoidectomy were sorted in this study.

2. Topical sucralfate showed substantial improvements in VAS at 24 hours, 7 days, and 14 days after surgery, as well as in pethidine use within 24 hours, diclofenac use at 7 days, wound healing rate at 14 days, and VAS at 24 hours, 7 days, and 14 days after surgery.

In conclusion, topical sucralfate decreased analgesic use, increased wound healing speed, and improved pain ratings. Therefore, topical sucralfate is a beneficial, safe, and practicable therapy following hemorrhoidectomy.

Reference: 

Rudiman, R., Hanafi, R. V., Evan, C., & Halim, F. (2022). The efficacy of topical sucralfate in improving pain and wound healing after haemorrhoidectomy procedure: A systematic review, meta‐analysis , and meta‐regression of randomised clinical trials. In International Wound Journal. Wiley. https://doi.org/10.1111/iwj.13901