title: A randomised study comparing systemic transdermal treatment and local application of glyceryl trinitrate ointment in the management of chronic anal fissure.
abstract: OBJECTIVE
  To compare a systemic transdermal therapeutic system with local application of glyceryl trinitrate ointment in the treatment of anal fissure.
  
  
  METHODS
  Prospective, multicentre, randomised trial.
  
  
  METHODS
  Three teaching hospitals, Turkey.
  
  
  METHODS
  89 outpatients with chronic anal fissure were randomly assigned to be treated with either transdermal (n = 52) or 0.2% glyceryl trinitrate ointment (n = 37).
  
  
  METHODS
  The patients were assessed at the sixth and the twelfth week after initial evaluation by physical examination, anoscopy, and anal manometry.
  
  
  METHODS
  Changes in the maximal anal resting pressure, healing rate.
  
  
  RESULTS
  Anal fissure was completely healed in 38 (73%) and 24 (64%) of the patients after 6 weeks and 48 (81%) and 27 (79%) of the patients in transdermal group and ointment group, respectively. Maximal anal resting pressure was reduced by 24% and 21% in transdermal and ointment groups, respectively.
  
  
  CONCLUSIONS
  Systemic transdermal application of glyceryl trinitrate gave a satisfactory healing rate, which was comparable to that of local application of ointment.
authors.affiliation: Mersin University Medical Faculty, Department of General Surgery, Mersin, Turkey. tcolak@mersin.edu.tr
authors.forename: Tahsin
authors.initials: T
authors.lastname: Colak
authors.forename: Turgut
authors.initials: T
authors.lastname: Ipek
authors.forename: Namik
authors.initials: N
authors.lastname: Urkaya
authors.forename: Arzu
authors.initials: A
authors.lastname: Kanik
authors.forename: Musa
authors.initials: M
authors.lastname: Dirlik
mesh_terms: D000279:Administration, Cutaneous; D000287:Administration, Topical; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D009824:Ointments
chemical_list: D009824:Ointments; D005996:Nitroglycerin