External hemorrhoid excision: Difference between revisions

Revision as of 12:22, 14 February 2017

Place patient in side-lying or prone position
Apply EMLA 1 hr prior to procedure
- Apply tape to each buttock with force directed laterally for better visualization
Inject local anesthetic (e.g. bupivacaine 0.5% with epi) with 30-gauge needle directly into dome of hemorrhoid as a single injection
- Alternatively, a perianal block can be used for local analgesia
Make elliptical incision in overlying skin to expose the thrombosis
- Remove the clot and the overlying skin through the incision site
Control bleeding by tucking corner of a small piece of gauze into the wound and tape buttocks together
- Leave in place for a few hours
Apply pressure dressing have patient remove 6-12 hr later when takes first stiz bath
Patient may apply soothing ointments (preparation H, Anusol HC, Lidocaine ointment)after dressing is removed
Provide follow up in 24-48hr

Authors:

@@ Line 19: / Line 19: @@
 #*Apply tape to each buttock with force directed laterally for better visualization
 #Inject local anesthetic (e.g. bupivacaine 0.5% with epi) with 30-gauge needle directly into dome of hemorrhoid as a ''single'' injection
-#*Alternatively, a [[Perianal Block]] can be used for local analgesia
+#*Alternatively, a [[perianal block]] can be used for local analgesia
 #Make elliptical incision in overlying skin to expose the thrombosis
 #*Remove the clot and the overlying skin through the incision site