Association of topical Tongxuekang Fumigation-washing with early wound recovery after hemorrhoidectomy: A retrospective cohort study

doi:10.3748/wjg.118686

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 7, 2026; 32(33): 118686
Published online Sep 7, 2026. doi: 10.3748/wjg.118686

Association of topical Tongxuekang Fumigation-washing with early wound recovery after hemorrhoidectomy: A retrospective cohort study

Zhen-Zhen Jiang, Sheng Yu, Zhi-Fa Zhu

Zhen-Zhen Jiang, Sheng Yu, Department of Traditional Chinese Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China

Zhi-Fa Zhu, Department of Integrated Traditional Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China

Author contributions: Jiang ZZ contributed to the study conception and design, data acquisition, data analysis and interpretation, and drafting of the manuscript; Yu S participated in data collection, follow-up coordination, outcome assessment, and critical revision of the manuscript for important intellectual content; Zhu ZF contributed to methodological guidance, statistical analysis supervision, interpretation of results, and final approval of the version to be published; all authors have read and approved the final manuscript and agree to be accountable for all aspects of the work.

AI contribution statement: The manuscript was written by the us, and that no part of the main text, including the Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion, was generated by ChatGPT, Grammarly, DeepL, or any other AI tools. No AI tool was used for language polishing, translation, data analysis, writing assistance, study design, interpretation of results, or image generation.

Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. PJ2025-02-25).

Informed consent statement: Given the retrospective nature of the study, the requirement for informed consent was waived.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Data sharing statement: There are no additional data available.

Corresponding author: Zhi-Fa Zhu, MD, Department of Integrated Traditional Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, No. 120 Wanshui Road, High Tech Zone, Hefei 230022, Anhui Province, China. yfy1922248@fy.ahmu.edu.cn

Received: February 27, 2026
Revised: March 20, 2026
Accepted: April 21, 2026
Published online: September 7, 2026
Processing time: 163 Days and 0.8 Hours

Abstract

BACKGROUND

Topical Tongxuekang fumigation-washing is used in some centers as local care after hemorrhoidectomy; however, its incremental benefit beyond thermal sitz baths and its mechanism remain unclear.

AIM

To assess whether Tongxuekang fumigation-washing improves early wound healing, pain, and short-term complications after hemorrhoidectomy in routine practice.

METHODS

This retrospective cohort study included 300 patients who underwent hemorrhoidectomy for mixed hemorrhoids or grade III-IV internal hemorrhoids at the First Affiliated Hospital of Anhui Medical University (January-December 2023) and completed follow-up. Patients were assigned by post-discharge care to either the Tongxuekang group (n = 150) or a control group (n = 150) receiving warm water/potassium permanganate sitz baths plus standard dressing changes. Data on demographics, perioperative variables, and outcomes were collected. The primary outcome was time to complete epithelialization. Secondary outcomes included pain (visual analog scale) on postoperative days 3, 7, and 14; edema and exudation scores; granulation tissue quality; complications (infection, bleeding, urinary retention); and healthcare utilization. Between-group comparisons were performed. Multivariable linear regression (epithelialization time) and logistic regression (infection, secondary hemorrhage) adjusted for confounders.

RESULTS

Baseline characteristics were comparable. Median time to epithelialization was shorter in the Tongxuekang group [18 (16, 21) days vs 21 (19, 24) days; P < 0.001]. Visual analog scale pain scores were consistently lower on days 3, 7, and 14, with faster improvement in edema and exudation. On day 14, good/excellent granulation tissue was more frequent in the Tongxuekang group (84.0% vs 68.0%; P = 0.001). Crude infection (4.0% vs 10.0%; P = 0.039) and secondary hemorrhage rates (2.0% vs 6.7%; P = 0.044) were lower with Tongxuekang, while urinary retention did not differ. Multivariable analysis showed Tongxuekang was independently associated with shorter epithelialization time (β = -2.3 days; 95%CI: -3.1 to -1.5) and lower infection risk (adjusted odds ratio = 0.36; 95%CI: 0.14-0.93). The reduction in secondary hemorrhage did not reach statistical significance (adjusted odds ratio = 0.28; 95%CI: 0.07-1.03; P = 0.054).

CONCLUSION

Tongxuekang fumigation-washing was associated with faster healing, better pain control, and reduced infection risk after hemorrhoidectomy. Findings reflect regimen-level associations rather than a defined mechanism. The apparent reduction in secondary hemorrhage requires confirmation in prospective studies.

Keywords: Hemorrhoidectomy; Fumigation-washing; Tongxuekang; Wound healing; Pain; Retrospective cohort study

Core Tip: Postoperative wound management after hemorrhoidectomy remains challenging due to pain, exudation, edema, and infection risk in the perianal region. This retrospective cohort study evaluated the effectiveness of topical Tongxuekang in routine postoperative care fumigation-washing in 300 patients evaluated the effectiveness of topical Tongxuekang fumigation-washing in routine postoperative care among 300 patients following hemorrhoidectomy. following hemorrhoidectomy. Compared with conventional sitz bath care, Tongxuekang fumigation-washing was associated with faster wound epithelization, lower postoperative pain scores, improved local edema and exudation, and reduced rates of infection and secondary hemorrhage. Multivariate analyses confirmed its independent association with shortened healing time and lower infection risk, supporting Tongxuekang fumigation-washing as a practical adjunct in postoperative local care pathways.