Ann Coloproctol.  2024 Dec;40(6):602-609. 10.3393/ac.2024.00570.0081.

Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study

• Brillantino A
• Marano L
• Grillo M
• Palumbo A
• Foroni F
• Vicenzo L
• Antropoli A
• Lanza M
• Sotelo MLS
• Sangiuliano N
• Maglio M
• Filosa R
• Abbatiello L
• Romano MP
• Passariello L
• Talento P
• Ioia G
• Rispoli C
• Armellino MF
• Bottino V
• Renzi A
• Bartone C
• Monaco L
• Mauro P
• Picardi S
• Menna MP
• Palladino E
• Mensorio MM
• Mosca V
• Gambardella C
• Brusciano L
• Docimo L

• KMID: 2563043
• DOI: http://doi.org/10.3393/ac.2024.00570.0081

Abstract

Purpose
Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.
Methods
This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group).
Results
The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). The percentage of patients reporting anal itching was also significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). All patients in the intervention group achieved complete wound healing 4 weeks after surgery, compared to 88 (82%) in the control group (P<0.01). No adverse events were reported.
Conclusion
The topical application of intimate cleansing gel (Antroclean Fisioderm) twice daily for 1 month following ultrasound scalpel-assisted hemorrhoidectomy appears to be associated with faster healing, reduced pain, decreased itching, and improved quality of life, without any adverse effects. Further larger and prospective randomized trials are recommended to confirm these findings.

Keyword

Hemorrhoids; Hemorrhoidectomy; Postoperative complications; Cleansing agents; Wound healing; Pruritus ani