A randomised study comparing systemic transdermal treatment and local application of glyceryl trinitrate ointment in the management of chronic anal fissure.
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.
Colak
Tahsin
T
Mersin University Medical Faculty, Department of General Surgery, Mersin, Turkey. tcolak@mersin.edu.tr
Ipek
Turgut
T
Urkaya
Namik
N
Kanik
Arzu
A
Dirlik
Musa
M
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
D009824:Ointments; D005996:Nitroglycerin