Comparing negative pressure wound therapy to conventional wound healing in post op fistulectomy patients

Fistulectomy, though effective for treating lower anal canal fistulas, is associated with longer operative times, larger incisions, delayed wound healing, and a higher risk of flatus incontinence. Negative Pressure Wound Therapy (NPWT), which applies controlled vacuum pressure to promote wound healing, may offer a solution to these challenges. This study evaluates the effectiveness of NPWT in enhancing postoperative recovery following fistulectomy.

This prospective study included 20 patients who underwent fistulectomy at Saveetha Medical College and Hospital. NPWT was applied postoperatively, and patient data-including wound characteristics, healing outcomes, and complications-were collected and analysed. The therapy aimed to accelerate granulation tissue formation, reduce tissue oedema, and minimise infection, thereby reducing hospital stay duration.

Among the 20 patients, the majority were male (75%) and aged between 31 and 60 years. Intersphincteric fistulas were most common (60%), and Escherichia coli was the predominant organism cultured (80%). Laboratory analysis showed normal haemoglobin levels, variable leukocyte and platelet counts, and stable albumin. Thyroid hormone levels varied widely and appeared to influence recovery. The mean postoperative hospital stay was 7.45 days. Patients aged 20-40 years who received NPWT had a shorter hospital stay (6.7 days) compared to those receiving traditional dressings (8.2 days).

NPWT appears to enhance wound healing and reduce hospital stay in post-fistulectomy patients. Although still an uncommon approach for anal fistulas, the promising outcomes observed in this study suggest NPWT may be a valuable addition to routine clinical practice and merit further investigation.