You are here

Article Text

Article menu
Therapeutics
Botulinum toxin A injections were more effective than glyceryl trinitrate for complete healing of anal fissure

https://doi.org/10.1136/ebm.4.6.175

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Brisinda G, Maria G, Bentivoglio AR, et al. A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. N Engl J Med. 1999 Jul 8;341:65-9.

    Question

    In patients with chronic anal fissure, are botulinum toxin injections more ef-fective than nitroglycerin ointment (glyceryl trinitrate [GTN]) for increasing the healing rate?

    Design

    Randomised (concealed), blinded (outcome assessor), controlled trial with 1- and 2-month follow-up.

    Setting

    Clinical centres in Rome.

    Patients

    50 adults (mean age 42 y, 50% women) with symptomatic chronic anal fissure, which was defined as evidence of posterior circumscribed ulcer with a large sentinel tag of skin, induration at edges, and exposure of horizontal fibres of the internal anal sphincter; and symptoms of post-defecatory or nocturnal pain, bleeding, or both for 2 months. Exclusion criteria were acute fissure, fissure associated with other conditions, or previous surgery in the anal canal. Follow-up was complete.

    Intervention

    Patients were allocated to 2 injections of botulinum toxin A, 20 U in 0.4 mL of solution (n = 25), or 0.2% GTN (10 g of 2% nitroglycerin diluted to 100 g with soft paraffin) …

    View Full Text