Short-Term Outcomes of Polycarbophil and Propionibacterium acnes Lysate Gel after Open Hemorrhoidectomy: A Prospective Cohort Study

Gaetano Gallo; Ugo Grossi; Gian Luca Di Tanna; Giulio Aniello Santoro; Gilda De Paola; Giuseppe Clerico; Alberto Realis Luc; Mario Trompetto; Giuseppe Sammarco

doi:10.3390/jcm9123996

Short-Term Outcomes of Polycarbophil and Propionibacterium acnes Lysate Gel after Open Hemorrhoidectomy: A Prospective Cohort Study

J Clin Med. 2020 Dec 10;9(12):3996. doi: 10.3390/jcm9123996.

Authors

Gaetano Gallo¹, Ugo Grossi², Gian Luca Di Tanna³, Giulio Aniello Santoro², Gilda De Paola¹, Giuseppe Clerico⁴, Alberto Realis Luc⁴, Mario Trompetto⁴, Giuseppe Sammarco⁵

Affiliations

¹ Department of Medical and Surgical Sciences, University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.
² Tertiary Referral Pelvic Floor Center, IV Surgery Unit, Treviso Regional Hospital, DISCOG, University of Padua, 31100 Treviso, Italy.
³ Statistics Division, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sidney, NSW 2042, Australia.
⁴ Department of Colorectal Surgery, S. Rita Clinic, 13100 Vercelli, Italy.
⁵ Department of Health Sciences, University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.

Abstract

Background: Pain is the most common complication after open excisional hemorrhoidectomy (OEH). We assessed the effectiveness of polycarbophil and Propionibacterium acnes lysate gel (Emorsan^®Gel) on pain control after OEH.

Research design and methods: Fifty consecutive patients undergoing OEH were included. All patients received stool softeners and oral analgesia in the post-operative period. Emorsan^®Gel was also used topically by the last 25 patients (Emorsan^®Gel group (EG)) until Post-Operative Day 20 (POD 20). The primary outcome was the effectiveness of Emorsan^®Gel on pain relief using an 11-point visual analogue scale (VAS). Morbidity, wound healing (WH), and time to work were documented at POD 1, POD 10, POD 20, and POD 40.

Results: Of the 50 patients enrolled, twenty-eight (56%) were males; median age, 49 (range, 28-73) years. The VAS score decreased over time in all patients, with significantly lower scores at POD 20 in the EG (1.44 (SD, 1.16) vs. 2.12 (0.93) in the control group (CG); p = 0.045). All patients in the EG achieved complete WH at last follow-up, compared to only 17 (68%) in the CG (p = 0.004). The likelihood of WH was 66% higher in the EG (OR, 1.66 [95%CI, 0.80-3.44; p = 0.172).

Conclusions: Emorsan^®Gel is safe and effective at reducing pain after EOH, promoting earlier WH compared to standard care treatment.

Keywords: Emorsan®Gel; hemorrhoidal disease; hemorrhoidectomy; pain; wound healing.