Wound management of complex anal fistulae

  In our busy lives, people may have forgotten to feel nature. We can feel the seclusion and silence of the deep green forest and search and capture the nature that we seem to have lost with the crisp birdsong in our ears.  The high complexity of anal fistula is currently recognized as a treatment problem at home and abroad, and is an intractable anorectal disease. Its etiology and pathology are mixed, and there is a certain degree of difficulty in diagnosis. Surgery is still its main treatment method, but the complications caused after surgery, such as large trauma, susceptibility to pus decay and necrotic tissue, delayed healing and a certain degree of anal dysfunction, bring inconvenience to patients’ lives and reduce their quality of life. Therefore, how to manage the postoperative trauma of anal fistula patients and promote their healing is a major problem in anorectal medicine. The actual fact is that you can find a lot of people who are not able to get a good deal on this.  The actual fact is that you can find a lot of people who have been in the marketplace for a long time, and they’ve got a lot of people who have been in the marketplace for a long time. Clinically more commonly used, such as red furnace muscle san, muscle yu red cream, etc.  2, Chinese medicine fumigation Chinese medicine fumigation sitz bath therapy is the characteristic management method of postoperative trauma in Chinese anorectal medicine, which is suitable for postoperative high complexity anal fistula, especially for patients with complex surgery, large postoperative trauma and easy contamination infection. The fumigation sitz bath can not only clean the trauma, reduce secretions, avoid trauma infection and edema, but also reduce the patient’s pain, soften the scar, improve trauma blood circulation and promote wound healing. For example, it is commonly used in clinical practice to fumigate the wound with Yinhua Sanhuang Healing Ulcer Soup (30g of Yinhua, 25g of Phellodendron, Phellodendron, Dandelion and Scutellaria, 28g of Rhubarb and 20g of Sophora).  3.Negative pressure closed drainage Negative pressure closed wound drainage technique is used to keep the wound under negative pressure by connecting the suction device with a special wound dressing, so as to achieve the purpose of wound treatment. Argenta and Morykwas invented the negative pressure assisted healing (VAC) system, which involves covering or filling a skin or soft tissue defect with a polyethylene alcohol hydrated algae salt foam dressing containing a drainage tube, sealing it with a bio-permeable membrane to make it a closed space, and finally connecting the drainage tube to a negative pressure source. This is a new treatment method to promote wound healing through controlled negative pressure. The advantage of this treatment technique is that the application of negative pressure increases the blood flow in the trauma to improve the blood supply around the trauma, reduce the trauma area fluid, reduce the trauma tissue edema, and finally play an effective role in controlling the infection, which can largely shorten the clinical treatment time and promote the healing of the trauma.  Growth factor is mainly used to promote the growth of granulation tissue, promote the vascularization of the trauma and accelerate the healing of the trauma. In post-operative anal fistula patients, recombinant bovine basic fibroblast growth factor gel combined with comfrey oil gauze change was used to shorten the time of pus decay removal and wound healing, and to promote the healing of post-operative trauma.  5.Bio dressing At present, bio dressing mainly includes: alginate dressing, hydrogel dressing, hydrocolloid dressing, biosynthetic dressing, growth factor dressing and nano dressing, etc. The ideal bio dressing should have good biocompatibility, non-toxic, non-antigenic, can block the invasion of bacteria, and can promote the function of wound healing.  6.TDP specific electromagnetic wave TDP generates a kind of integrated electromagnetic wave with different wavelength and different energy, which can improve blood circulation and tissue nutrition, enhance metabolism, improve immune function, and then play the role of anti-inflammation, swelling and promote the growth of granulation tissue, so that the wound pain is obviously reduced, the healing time is shortened and the healing effect is effectively played.  Of course there are other very good methods to promote wound healing, and I believe that as long as we make unremitting efforts, we will definitely pursue the methods that make patients recover faster.