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This study evaluated the efficacy of\n                      <jats:italic>Propionibacterium<\/jats:italic>\n                      extract gel (PeG) in promoting wound healing and reducing pain, burning, and itching compared to an ointment containing hyaluronic acid and silver sulfadiazine (HA-SSD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter, phase\u00a0IV randomized controlled trial, patients undergoing open excisional hemorrhoidectomy were randomly assigned in a 1:1 ratio to receive PeG or HA-SSD. The primary outcome (wound healing) was evaluated on the basis of grade of epithelialization. Secondary outcomes (pain, burning, and itching) were assessed using a 10-point visual analogue scale at baseline and 10, 20, and 40\u00a0days postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 119 screened patients, 64 (53.78%) received PeG and 55 (46.22%) received HA-SSD. The baseline characteristics were comparable. After 20\u00a0days, 46 (75.4%) of the PeG group patients had an epithelialization grade\u2009&gt;\u200950% (vs\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937, 72.6% of the HA-SSD group;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). By day\u00a040, complete wound healing occurred in 52 (85.3%) of the PeG group patients (vs\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925, 52.1% of the HA-SSD group;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Both treatments reduced postoperative pain over time, with no significant between-group difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.24). PeG demonstrated a superior reduction in burning (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and itching (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Patient satisfaction was higher with PeG (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945, 75% vs\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099, 18.8% of the HA-SSD group,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with no reported adverse reactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PeG was more efficient than HA-SSD in promoting wound healing, alleviating burning and itching, and enhancing patient satisfaction following hemorrhoidectomy. This study supports the safety and effectiveness of PeG as a therapeutic option for postoperative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>NCT06872151, retrospectively registered on 6 March 2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-026-03381-x","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:47:06Z","timestamp":1782222426000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the efficacy of a Propionibacterium extract gel in wound healing and symptom relief after open excisional hemorrhoidectomy: a randomized clinical study"],"prefix":"10.1007","volume":"30","clinical-trial-number":[{"clinical-trial-number":"nct06872151","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7756-9727","authenticated-orcid":false,"given":"S.","family":"Deidda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Eberspacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Argiolas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ventrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Testa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ascanelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Rossin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Lisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mascagni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Zorcolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"3381_CR1","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.jviscsurg.2024.03.005","volume":"161","author":"N Fathallah","year":"2024","unstructured":"Fathallah N, Alam A, Rentien AL et al (2024) Hemorrhoidal disease: epidemiological study and analysis of predictive factors for surgical management. 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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have obtained consent from all participants for the publication of any data contained within the manuscript.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"142"}}