{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T06:25:49Z","timestamp":1759991149406},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2001,12,20]],"date-time":"2001-12-20T00:00:00Z","timestamp":1008806400000},"content-version":"vor","delay-in-days":110,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2001,9]]},"abstract":"<jats:p> <jats:bold>Introduction<\/jats:bold>: Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. The duration of the effect of topical 0.2% glyceryl trinitrate (GTN) ointment on anodermal blood flow in fissure and normal areas was investigated in patients with chronic anal fissures.<\/jats:p><jats:p> <jats:bold>Methods<\/jats:bold>: Six patients with chronic anal fissures in the posterior midline participated in the study. Blood flow measurements were performed on the anoderm using laser Doppler flowmetry before and immediately after the topical application of 0.2% GTN ointment and subsequent readings were taken at 5, 15, 30, 45 and 60 min in all four quadrants.<\/jats:p><jats:p> <jats:bold>Results<\/jats:bold>: The mean anodermal blood flow in the fissure region is significantly lower than the mean blood flow of the rest of the anoderm before 0.2% GTN ointment is applied (228.7 \u00b1 61.8 flux units <jats:italic>vs<\/jats:italic> 439.3 \u00b1 25.5 flux units, respectively; <jats:italic>P<\/jats:italic> &lt; 0.05). Immediately after the application of local 0.2% GTN ointment there is a significant increase in anodermal blood flow over the anal fissure region (457.8 \u00b1 56.5 flux units; <jats:italic>P<\/jats:italic> &lt; 0.05) compared to the rest of the anoderm (457.4 \u00b1 30.8 flux units). This increase is most marked at 5 min post\u2010GTN ointment application in the fissure area (474.6 \u00b1 41.1 flux units) and the blood flow in the fissure region is consistently above the rest of the anoderm for most of the 60 min.<\/jats:p><jats:p> <jats:bold>Conclusion<\/jats:bold>: There is clearly reduced blood flow to the chronic anal fissure region compared to the rest of the anoderm. Topical application of glyceryl trinitrate ointment seems to significantly improve the blood flow to the fissured area in the first hour. This may therefore help in the healing of chronic anal fissures.<\/jats:p>","DOI":"10.1046\/j.1440-1622.2001.02182.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:47:33Z","timestamp":1047350853000},"page":"548-550","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures"],"prefix":"10.1111","volume":"71","author":[{"given":"Keith B.","family":"Kua","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemant M.","family":"Kocher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Kelkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameet G.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,12,20]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"BallC.The Rectum its Diseases and Developmental Defects. London: Hodder & Stoughton 1908."},{"key":"e_1_2_6_3_2","unstructured":"CormanML.Anal fissure. In: Corman ML (ed.)Colon and Rectal Surgery 4th edn. Philadelphia: Lippincott\u2010Raven 1998; 206\u201323."},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(82)90522-0"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730609"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02554725"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02054409"},{"key":"e_1_2_6_8_2","first-page":"486","article-title":"Surgical correction of chronic internal anal (sphincteric) contracture.","volume":"25","author":"Eisenhammer S.","year":"1951","journal-title":"S. Afr. Med. 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