Detection and Its Significance of Wound-healing Process after Hemorrhoidectomy by Measuring Its Tissue Blood Flow

The wound-healing process of 30 patients (13 males and 17 females) after hemorrhoidectomy was investigated by measuring the wound tissue blood flow in association with 3 growth factors and plasminogen activators. The wound-healing process was clearly divided into four phases: On days 1 to 5 after hemorroidectomy, the tissue blood flow was a low value and did not fluctuate, which was defined as the inflammatory phase. On days 6 to 12, it increased linearly, which was defined as the proliferative phase. On days 13 to 24, the tissue blood flow was a high value, which was defined as the remodeling phase. From the 25th postoperative day, the blood flow began to decline, which was defined as the maturity phase. In the inflammatory and proliferative phases, plasma fibrinogen and vascular endothelial growth factor increased in correlation with each other. During this period, both tissue and urokinase type plasminogen activators were elevated. From the early proliferative phase to the middle of the remodeling phase, the platelet derived growth factor increased. At the late stage of the remodeling phase, the activity of the transforming growth factor (TGF) reached the peak. Then, with the decline of TGF activity, the wound healing reached the maturity phase. It is concluded that the process of wound healing after hemorrhoidectomy involves complex interactions between various mediators and extracellular matrix in a timely fashion. Postoperative wound edema and bleeding occasionally occur in the normal process of wound healing after hemorrhoidectomy.