The Effects of Phellodendron Decoction on Wound Healing of Anal Fistula after Anal Fistulotomy

Exploration of the anti-inflammatory, analgesic, and wound healing activities of Bletilla Striata polysaccharide

Bletilla Striata (BS) Polysaccharide (BSP) is one of the main components of the traditional Chinese medicinal plant Bletilla striata Rchb. F. BSP has been widely used in antimicrobial and hemostasis treatments in clinics. Despite its use in skin disease treatment and cosmetology, the effects of BSP on wound healing remain unclear. Here we investigated the anti-inflammatory, antioxidant, and analgesic effects of BSP and explored its impact on morphological changes and inflammatory mediators during wound healing. A carrageenan-induced mouse paw edema model was established to evaluate the anti-inflammatory effect of BSP. Antioxidant indicators, including NO, SOD, and MDA, were measured in the blood and liver. The increased pain threshold induced by BSP was also determined using the hot plate test. A mouse excisional wound model was applied to evaluate the wound healing rate, and HE staining and Masson staining were used to detect tissue structure changes. In addition, ELISA was employed to detect the expression of pro-inflammatory cytokines TNF-α, IL-6, and IL-1β in serum. BSP significantly decreased the concentration of NO and MDA in serum and liver while increasing SOD activity. It exhibited a notable improvement in mouse paw edema induced by carrageenan. BSP dose-dependently delayed the appearance of licking behavior in mice, indicating its analgesic effect. Compared to the control group, the wound healing rate was significantly improved in the BSP treatment group. HE and Masson staining results showed that the BSP and 'Jingwanhong' ointment groups had slightly milder inflammatory responses and significantly promoted more new granulation tissue formation. The levels of serum inflammatory mediators TNF-α, IL-1β, and IL-6 were reduced to varying degrees. The results demonstrated that BSP possesses anti-inflammatory, antioxidant, analgesic, and wound healing properties, and it may promote wound healing through inhibition of inflammatory cytokine synthesis and release.

Analysis of the permeable and retainable components of Cayratia japonica ointment through intact or broken skin after topical application by UPLC-Q-TOF-MS/MS combined with in vitro transdermal assay

Cayratia japonica ointment has been used for many years to promote wound healing after perianal abscess surgery. This study aimed to determine the skin-permeable and skin-retainable components of Cayratia japonica ointment after topical application to intact or broken skin via UPLC-Q-TOF-MS/MS analysis and in vitro transdermal assay. Moreover, a combination of semi-quantitative and molecular docking analyses was performed to identify the main active components of the Cayratia japonica ointment and the probable phases of the wound healing process that they act on. Modified vertical Franz diffusion cells and abdominal skin of rats were selected for the in vitro transdermal study. Mass spectrometry data were collected in both positive and negative ion modes. A total of 7 flavonoids (schaftoside, luteolin-7-O-glucuronide, luteolin-7-O-glucoside, apigenin-7-O-glucuronide, luteolin, apigenin, and chrysin) and 1 coumarin (esculetin), were found to permeate and/or retained by intact or broken skin. Among them, the flavonoids were more permeable through intact/broken skin and exhibited stronger binding affinities for targets related to the inflammatory and proliferative phases of wound healing. This study suggests that the flavonoids in Cayratia japonica ointment are most likely the main active components and are crucial at the inflammatory and proliferative phases of wound healing.

Evaluation of the mechanical properties and clinical application of nickel-titanium shape memory alloy anal fistula clip

Objective

The study investigates the mechanical properties of a nickel-titanium shape memory alloy anal fistula clip (NiTi-AFC), studies the surgical method of treating anal fistula, and evaluates its clinical efficacy.

Methods

The anal fistula clip was formed in nickel-titanium alloy with a titanium content of 50.0%-51.8%. The mechanical properties and chemical properties were tested. A total of 31 patients with anal fistula were enrolled between 1 January 2020 and 1 January 2023. All patients underwent internal orifice closure surgery using NiTi-AFC, and anorectal magnetic resonance or ultrasound was performed before surgery and 6 months after surgery for diagnosis and evaluation. Fistula cure rates, length of stay, perianal pain, and Wexner incontinence scores were retrospectively compared between patients treated with NiTi-AFC and patients treated with other surgical methods.

Result

NiTi-AFC has a density of 6.44-6.50 g·cm-3, with a shape-restoring force of 63.8 N. The corrosion rate of NiTi-AFC in 0.05% hydrochloric acid solution at atmospheric pressure and 20°C is approximately 6.8 × 10-5 g·(m·h)-1. A total of 31 patients (male/female: 19/12, age: 43.7 ± 17.8 years) were included. Among them, 22.6% (7) had multiple anal fistula, 16.1% (5) had high anal fistula, and 48.3% (15) had perianal fistula Crohn's disease. In total, 12.9% (4/31) did not achieve primary healing, underwent fistula resection, and eventually recovered. A retrospective analysis showed that the fistula healing rate, length of stay, and anal pain of NiTi-AFC treatment were similar to those of other traditional surgeries, but the Wexner incontinence score was significantly lower.

Conclusion

NiTi-AFC has shape memory properties, corrosion resistance, superelastic effect, and surface cell adhesion. It is applied to internal orifice closure surgery of anal fistula, with good therapeutic effect, and can protect the anal function.

The efficacy and safety of Chinese herbal medicine for reducing wound complications after anal fistula surgery: A protocol for systematic review and meta-analysis

BACKGROUND

Anal fistula is one of the most common diseases in anorectal surgery. The wound healing after surgery can affect the prognosis of patients. We conducted a protocol for systematic review and meta-analysis to assess the efficacy and safety of Chinese herbal medicine for reducing wound complications after anal fistula surgery.

METHODS

We have prepared this protocol in accordance with the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA-P) statement. We will search the following databases: the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, Chinese Biomedical Literature Database, Pubmed, Embase, Web of Science, and the Cochrane library. Two authors will independently assess the risk of bias of the included studies based on the bias risk assessment tool recommended in the Cochrane "Risk of bias" assessment tool. All calculations are carried out with STATA13.0 software.

RESULTS

A synthesis of current evidence of Chinese herbal medicine for wound management after anal fistula surgery will be shown in this protocol.

CONCLUSION

This study may provide more convincing evidence to help clinicians make decisions when dealing with anal fistula patients after surgery.