A one year randomized control study to compare the outcomes of perianal surgery wounds when using silver colloidal solution spray vs. povidone iodine sitz-bath at kles dr. prabhakar kore hospital

Abstract

Anorectal diseases are the group of disorders that arise at the juncture of rectum and anal canal. The commonly describedbenign anorectal disorders include Haemorrhoids, Anorectal Abscess, Fissure-in-Ano, and Fistula-in-Ano. These disorders have been treated by surgical interventions like Haemorrhoidectomy, Incision and Drainage, Fissurectomy, Fistulectomy etc. These wounds are usually not sutured and are kept open due to their proximity to the anal opening and thus, very high chances of infection. Sitz-Bath has been frequently recommended by physicians for a variety of post-perianal surgical wounds. Sitz-Bath is efficacious in relieving pain.Healing occurs due to the antiseptic properties of povidone iodine which is used as an additive to the Sitz-bath. Privacy, need for a sitz-bath tub or a flat bucket and multiple sittings every day decrease the Sitz-bath usage in the majority of low socioeconomic population due to the inconvenience, lack of privacy and lack of time, which may ultimately lead to non-compliance and improper wound healing. In spray form, the silver colloidal solution has been in use primarily for the ulcerative superficial wounds for the purpose of healing e.g. Diabetic foot ulcers, Bedsores, Debrided post-operative wounds of extremities, Surgical site infection wounds etc. Apart from its antiseptic property, it also acts as a washing agent and due to this quality, it could be used for the post-operative perianal surgical wounds for healing. In this study we want to assess the novel approach of silver spray application over these perianal wounds and the superiority in terms of less time consumptionand convenience to the patient as it would not require the tedious procedure of taking a sitz-bath as the patients could spray the wound as per their convenience. The ease of application with the spray formulation is another benefit as it doesn’t command the patient towards the inconvenience of exclusive privacy which is required for taking a sitz-bath.