Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .
A prospective, randomized, controlled trial of primary wound closure after lateral internal sphincterotomy.
BACKGROUND Much of the  lateral internal sphincterotomy ( LIS )  complications is related to LIS incision . In this study , incisions sutured primarily or left to secondary healing after open LIS procedure are compared regarding the wound healing and complications associated with wounds . METHODS Planning a prospect i ve , r and omized clinical study , 39 patients were separated into two groups .  Open LIS was performed on both of the groups . While the incisions of the patients in group 1 ( n = 22 ) were closed with two interrupted sutures using 3 - 0 chromic catgut , the incisions of the patients in group 2 ( n = 17 ) were left open . The patients were followed up for 90 days postoperatively . RESULTS Hematoma in 1 ( 4.5 % ) , ecchymosis in 7 ( 31.8 % ) , and wound infection in 1 ( 4.5 % ) developed in patients of group 1 . In this group no significant external bleeding was seen . Wound healing duration was 15.05 + /- 5.60 days . In group 2 no hematoma developed ( P = 0.98 ) , but 2 ( 11.7 % ) ecchymoses ( P = 0.25 ) , 4 ( 23.5 % ) , wound infections ( P = 0.14 ) , and 3 ( 17.6 % ) postoperative significant external bleedings ( P = 0.07 ) were seen . Wound healing duration was 33.94 + /- 6.67 days ( P < 0.001 ) . CONCLUSIONS To achieve early wound healing , primary closure of open LIS incision is useful , but this technique has no significant effect on wound-related complications in comparison with secondary healing
Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .