External Hemorrhoids Surgery
It is generally believed that external hemorrhoids require surgery. Thrombosis, varicose external hemorrhoids may take a non-surgical treatment, and connective tissue external hemorrhoids do not need surgery.
- Thrombosis external hemorrhoids: because hemorrhoids form small, broken blood vessels, blood clot into the thrombus named. Patients have severe anal pain, the incidence of 7 to 10 days, after the treatment of pain, although reduced, but local mass hard Needless need surgical dissection thrombosis. For some patients with inoperable or do not want surgery, then continue to use non-surgical therapy. Commonly used Qingreliangxue the governing law intended to clear the main Selection of cooling to yellow decoction, commonly used drugs habitat, Dan, Huaijiao, skullcap, Health Burnet and so on. Commonly used medicines, there are clear solution tablets, each 5 to 3 times a day, orally. Common external treatment combined with Sophora soup Fumigation garlic soup or hot water bath with potassium permanganate, every 20 minutes, after fumigation topical cream Xiaozhi cream or golden day for a change.
- Varicose veins of the external hemorrhoids treatment of hemorrhoids, surgery can also be non-surgical therapy. Usually with surgical stripping hemorrhoid venous plexus,
① Operation: lateral position or lithotomic position, routine disinfection of shop towels, local anesthesia. In the middle of skin tags do radial incision, excision side flaps, leather trim edge, make it into a spindle or radically wound. Topical haemostatic powder, Vaseline gauze oppression fixed release.
② After treatment: After daily with Sophora soup or 1: 5000 potassium permanganate solution hot bath, and then replace the dressing to heal. If exposed to inflammation, response to disease treatment. Surgical therapy is used instead of heat and dampness, blood stasis method, select castor seed pass through the blood Shensi Decoction taken orally, common castor seed, Alisma, Treats, skullcap, Dan, red peony root, angelica, Achyranthes, Chuanxiong drug. Or with the application of Maren, intestines and other proprietary piece, so that patients maintain a smooth stool, temporary toilet do not force hard earned, tap the anus after stool several times, and 20 times anal contraction. No inflammation without foreign rule, if the inflammation and edema or potassium permanganate bath available Sophora soup Fumigation, Fumigation after topical Xiaozhi cream once a day.
- Connective tissue external hemorrhoids do not need special treatment, just for general processing. Patients are required to adjust in bowel habits, avoid squatting too long; after stool or bath before bedtime with warm water; keep the skin anus dry. When concurrent inflammatory throat occurs; available Fumigation Bath, topical Xiaozhi cream and yellow ointment can also be appropriate to give antibiotics. If the external hemorrhoids perianal skin flap too much influence hygiene person, or repeated inflammatory edema, surgery may be appropriate.
- Inflammatory bowel habits adjust external hemorrhoids only prevent constipation, avoid drinking and eating hot spicy food, after using potassium permanganate bath, or use of the spectrum irradiation. Xiaozhi necessary topical cream once a day. Or the use of oral Metronidazole (Flagyl) 0.4 g, 2 times a day. For long-term inflammatory edema subside, and there could be surgical resection. In the acute phase of the inflammatory edema, according to TCM internal medicine, with fumigation, topical and other external treatment.
External hemorrhoids surgery incision choice part of the external hemorrhoids and mixed hemorrhoid surgical resection, because of anal muscle wrinkled skin radial distribution, taking radial incision, postoperative response to light, to fit neatly, the prognosis does not affect wound anal function. External hemorrhoids artery corresponding more with the mother, it cut more choice in lithotomy position 3,7,11 points. For larger varicose external hemorrhoids or external hemorrhoids epicanthic female front side, single use radial incision, unresectable external hemorrhoids, if left to do too much skin, then postoperative inflammation, pain, skin hyperplasia legacy epicanthus do external hemorrhoids; If the expansion of the angle between the removal of all external hemorrhoids, the anal skin damage caused by excessive anal stenosis.
To make up for these shortcomings, surgery may be added to a small incision on one side or both sides of the incision, stripped edge venous plexus, suture the skin to do. If the skin do involution poor, prone to pain, swelling, skin do Alice straight, and slow healing.
External hemorrhoids surgery should pay attention to the orientation of the incision, the incision size and anesthesia changes in postural changes, to ensure that the wound to be neatly fit.
Current methods of treatment of hemorrhoids summarized as conservative treatment and surgical treatment of two categories.
- Conservative treatment refers to internal medicine, external medicine, suppository, fumigation and other methods.
- Surgical treatment refers to drug injection, suture ligation, surgery, freezing, laser and other methods.
Specific surgical operation
Lateral position. Benzalkonium bromide solution after disinfection with 1:1000 surgical area, in thrombus as radiation or spindle-shaped notch cut into small pieces of skin, you can see dark red blood clots. With a hemostat to remove the light pressure on both sides. When adhesions, or can be added as a separate block resection. Not to sew wounds, gauze oil blockage.
Postoperative 1:5000 potassium permanganate hot water bath, 3 times a day.