A prospective, randomized, controlled trial of primary wound closure after lateral internal sphincterotomy

Abstract

Background: Much of the lateral internal sphincterotomy (LIS) complications is related to LIS incision. In this study, incisions sutured primarily or left to secondary healing after open LIS procedure are compared regarding the wound healing and complications associated with wounds.

Methods: Planning a prospective, randomized clinical study, 39 patients were separated into two groups. Open LIS was performed on both of the groups. While the incisions of the patients in group 1 (n = 22) were closed with two interrupted sutures using 3-0 chromic catgut, the incisions of the patients in group 2 (n = 17) were left open. The patients were followed up for 90 days postoperatively.

Results: Hematoma in 1 (4.5%), ecchymosis in 7 (31.8%), and wound infection in 1 (4.5%) developed in patients of group 1. In this group no significant external bleeding was seen. Wound healing duration was 15.05 +/- 5.60 days. In group 2 no hematoma developed (P = 0.98), but 2 (11.7%) ecchymoses (P = 0.25), 4 (23.5%), wound infections (P = 0.14), and 3 (17.6%) postoperative significant external bleedings (P = 0.07) were seen. Wound healing duration was 33.94 +/- 6.67 days (P <0.001).

Conclusions: To achieve early wound healing, primary closure of open LIS incision is useful, but this technique has no significant effect on wound-related complications in comparison with secondary healing.