Vaseline zinc oxide and finger anal dilatation for the treatment of anal fissure: a comparison cohort study

Anal fissure is one of the most painful diseases of the anus region. Diverse approaches for managing this condition have been examined, however, no unanimous approach has been achieved. The current study aimed to evaluate the efficacy of topical triamcinolone NN plus Vaseline zinc oxide and finger dilation versus triamcinolone NN alone to manage anal fissures.

 The current comparative cohort study has been conducted on 90 patients suffering from anal fissures. The group of topical Vaseline zinc oxide plus finger dilation (n=45) was prescribed to administer the blend of triamcinolone NN (1 cc) and Vaseline zinc oxide (2 cc) topically three times a day and to enter their little finger into the anus 18-20 times per day. Since the second week, they used the index finger. Topical triamcinolone NN only was administered by another group (n=45). The patients were weekly followed for three weeks and assessed pain severity using the Visual Analog Scale and bleeding incidence. The obtained data was analyzed by SPSS software (version 23). The Chi-square test, student t-test, and repeated measured ANOVA were used for data analysis. The P-value of less than 0.05 was defined as the level of significance.

Pain intensity (P =0.057) and bleeding (P =0.75) were similar in both groups at baseline, while the cases experienced significantly lower frequencies of bleeding in all follow-up visits (P <0.001). Pain severity was reduced significantly in cases within three weeks after the interventions (P-value<0.001) as well as the controls (P =0.021); however, the presented scores by the controls were significantly higher in all follow-up visits (P <0.001).

According to the findings of this study, the administration of topical Vaseline zinc oxide and daily anal sphincter self-massage can effectively lead to anal fissure symptoms control; however, further studies with a more prolonged period of follow-up are strongly recommended.