Short Term Results of Platelet-rich Plasma in the Treatment of Chronic Anal Fissure

NCT ID: NCT04320498

Last Updated: 2022-04-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-01

Study Completion Date

2021-01-02

Brief Summary

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Autologous PRP currently has many uses in surgical and medical therapy. Compared with other regenerative therapies, PRP is easy-to-prepare, low-cost, and does not require complex equipment. The use of autologous PRP avoids immunological side effects. Data is lacking on the use of PRP in the treatment of anal fissure. This study evaluated PRP as an alternative medical treatment for chronic anal fissures.

Detailed Description

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. Chronic anal fissures are mucosal ulcers in the anal canal distal to the dentate line and most often present with severe pain and bleeding during defecation. The symptoms of chronic anal fissures persist for more than 8 weeks and do not respond well to medical treatment. This randomized controlled trial investigated the effects of PRP on the healing of chronic anal fissures, which can be considered as nonhealing ulcers. High anal sphincter pressure can cause chronic anal fissures by producing mucosal ischemia in the posterior anal canal that delays wound healing, ultimately resulting in a chronic nonhealing ulcer. Increased anal sphincter pressure induces constipation and spasms in the arterioles that form the mucosal blood supply.9 Botulinum toxin, calcium channel blockers, nitrates, or surgery promote healing by reducing anal sphincter pressure, and increasing blood flow.

Autologous PRP has been shown to speed recovery and improve pain and quality of life scores of patients treated for chronic wounds.PRP reduced complaints and accelerated epithelialization and healing in patients with chronic anal fissures. PRP, which can be obtained easily and did not have any harmful patient effects may be an alternative to surgery in patients with chronic anal fissures. The duration of symptoms should be considered during the evaluation of treatment options.

Conditions

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Anal Fissure Chronic PRP

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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control group

The control patients self-administered topical glyceryl trinitrate, in the perianal area twice a day (Anrecta, Consentis Pharmaceuticals, Istanbul, Turkey)

Group Type ACTIVE_COMPARATOR

Anrecta

Intervention Type DRUG

self-administered topical glyceryl trinitrate (anrecta), in the perianal area twice a day

sitz bath

Intervention Type BEHAVIORAL

participants were told to take a hot water sitz bath once a day

nutrition regulation

Intervention Type DIETARY_SUPPLEMENT

The study participants were told to eat a fiber-rich diet and to drink least 2 liters of water daily

PRP group

PRP was injected locally in the anal fissure area and glyceryl trinitrate was administered twice daily in the perianal region as in the control group.

Group Type EXPERIMENTAL

prp injection

Intervention Type BIOLOGICAL

PRP was injected locally in the anal fissure area and glyceryl trinitrate was administered twice daily in the perianal region as in the control group.

Anrecta

Intervention Type DRUG

self-administered topical glyceryl trinitrate (anrecta), in the perianal area twice a day

sitz bath

Intervention Type BEHAVIORAL

participants were told to take a hot water sitz bath once a day

nutrition regulation

Intervention Type DIETARY_SUPPLEMENT

The study participants were told to eat a fiber-rich diet and to drink least 2 liters of water daily

Interventions

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prp injection

PRP was injected locally in the anal fissure area and glyceryl trinitrate was administered twice daily in the perianal region as in the control group.

Intervention Type BIOLOGICAL

Anrecta

self-administered topical glyceryl trinitrate (anrecta), in the perianal area twice a day

Intervention Type DRUG

sitz bath

participants were told to take a hot water sitz bath once a day

Intervention Type BEHAVIORAL

nutrition regulation

The study participants were told to eat a fiber-rich diet and to drink least 2 liters of water daily

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Platelet rich plasma injection rectoderm

Eligibility Criteria

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Inclusion Criteria

* between 18 and 65 years of age with painful defecation of at least 2 months duration and diagnosed with anal fissure between January and October 2019 were included.
* The diagnosis of chronic anal fissure required :
* the presence of internal sphincter muscle fibers in the base of the fissure
* hypertrophic anal papillae on digital rectal examination

Exclusion Criteria

* Patients with physical examination findings that did not meet the definition of chronic anal fissure
* with painful defecation for less than 2 months,
* atypical fissure location or multiple anal fissures away from the midline
* inflammatory bowel disease
* cancer
* history of trauma
* tuberculosis
* immune suppression
* sexually transmitted disease
* a disease possibly associated with a fissure
* a history of anal surgery
* previous treatment for anal fissure
* current pregnancy .
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul Medipol University Hospital

OTHER

Sponsor Role collaborator

KTO Karatay University

OTHER

Sponsor Role lead

Responsible Party

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Yusuf Tanrikulu

Assoc Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Karatay Medicana Üniversitesi

Konya, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Other Identifiers

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122

Identifier Type: -

Identifier Source: org_study_id

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