Effect of isosorbide dinitrate ointment on anal fissure.
Songun I, Boutkan H, Delemarre JB et al. Dig Surg 2003;20:122-126.
The authors are all affiliated with the Departments of Surgery at either the Rode Kruis Ziekenhuis, The Hague or Leiden University Medical Center, Leiden, The Netherlands. This study is too recently published to have been included in the review abstracted above. The authors treated 100 consecutive patients with anal fissures who were seen in a general surgery practice in their hospital between june 1997 and January 2000. Treatment involved the use of isosorbide dinitrate (ISDN) ointment. There was a 93% primary healing rate, with those not responding being treated with surgery. Of the 93 patients successfully treated with ISDN, 13 had recurrence of anal fissures during the 1-year follow-up. These patients were treated again with ISDN, with seven patients being cured and six requiring surgery. Regarding adverse effects of ISDN use, seven patients suffered temporary headaches. The authors, who recommend ISDN ointment for first-choice treatment of primary and recurring anal fissures, list the formulation of the 1% ISDN ointment and recommend five applications daily during the day.
Copyright International Journal of Pharmaceutical Compounding Jan/Feb 2004
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