The Effect of Topical Timolol 0.5% Solution on the Healing of Postoperative Anal and Perianal Wounds; a Randomized Controlled Trial

Background: Wound healing after anal surgery remains a challenging problem. May topical agents have been used to deal with this problem with variable results? Topical timolol was used successfully in the management of chronic and refractory wounds.
Aim: This study aimed to assess the effect of topical timolol 0.5% solution on healing of postoperative anal and perianal wounds.
Patients and methods: 70 participants with anal and perianal wounds were enrolled in this randomized controlled trial. Patients were randomized into two equal groups (35 in each): The timolol group where patients were treated with topical timolol maleate 0.5% solution. The control group wher patients were treated with normal saline solution.
Results: Preoperative patients’ characteristics and Quality of life (QoL) were comparable between the two groups. Regarding the % of healing at postoperative 1 month, outcome data showed that there were no significant results (75.7 ± 6 % vs 75.2 ± 10.4 %, P=0.81) and healing time (6.2 ± 2.3 vs 5.9 ± 1.7 weeks, P=0.54) between the timolol and control groups respectively. Despite the significant improvement in QoL at postoperative 6 months in both groups, non-statistical significant differences were found between both groups regarding postoperative QoL scores at 1, 3, and 6 months. Pain assessment and complications were comparable between both groups and all complications were managed successfully.
Conclusion: Topical timolol 0.5% solution showed no significant advantage over routine postoperative wound care in the case of anal surgical wounds. Further studies using different forms, doses, and concentrations are required.