the Affiliated Hospital of Putian University

Anorectal fistula refers to a granulomatous duct located around the rectum and anus. It is mostly caused by infection of the soft tissues surrounding the rectum and anus, and often presents with symptoms such as swelling, pain, and itching around the anus. This causes inconvenience to the patient's daily life. The ideal surgical treatment for anorectal fistula should eliminate sepsis and promote the healing of the duct, while preserving the sphincter and the defecation mechanism. Abbas mentioned the predictive factors for postoperative results of anorectal fistula. Some sinus tracts are relatively deep, the surgical scope is relatively large, the destruction of the rectal ring, which causes a significant feeling of anal distension, will affect the defecation function. After the operation, effective intervention measures should be taken to promote the patient's recovery. Kegel exercise, also known as pelvic floor exercise, is a regular upward lifting and contraction of the anus. It can promote peripheral blood circulation, relieve pain, improve the function of the anal sphincter, and also enhance the strength around the anus to prevent the occurrence of anal incontinence. It is mainly used for the treatment and improvement of anal diseases. When patients perform pelvic floor exercises, they should also pay attention to a light diet and avoid using spicy and irritating foods to avoid affecting the effect of the pelvic floor exercise. Combined with the new pain management concept of this department, for postoperative patients with anorectal fistula, pelvic floor exercise intervention is carried out for constipation and anal heaviness, and the efficacy is observed.

This study aims to investigate whether the dynamic pain assessment and management system can alleviate postoperative pain in patients with incarcerated mixed hemorrhoids and reduce the incidence of complications. A total of 64 eligible patients were enrolled and randomly divided into two groups, with the specific grouping and intervention methods as follows:
① Control Group: Routine drug analgesia and conventional nursing education were adopted.
② Study Group: Patients were managed with the dynamic pain assessment and management system, which included preoperative administration of analgesic drugs, postoperative traditional Chinese medicine (TCM) fumigation, wrist-ankle acupuncture for pain relief, and personalized nursing education.
The study evaluated the effect of the dynamic pain assessment and management system on postoperative analgesia by comparing the Numerical Rating Scale (NRS) scores for pain, recording the Visual Analogue Scale (VAS) scores for quality of life, and analyzing the incidence of complications among patients in different groups. The primary hypothesis of the study is that, compared with routine pain management methods, the dynamic pain assessment and management system can significantly reduce postoperative pain in patients, improve their quality of life, and decrease the incidence of complications (such as bleeding and urinary retention).

This study compares three different ways surgeons close the wound after removing hemorrhoids (piles): leaving it completely open, stitching it completely closed, or stitching only half of it closed (semi-closed). The goal is to see which method leads to faster healing, less pain, fewer complications, and better long-term results. Patients undergoing hemorrhoidectomy will be randomly assigned to one of the three groups. All patients will receive standard post-operative care. Researchers will measure healing time, pain levels, need for pain medication, hospital stay, complications, and check if hemorrhoids come back within one year.