Pain control and early wound healing effect using sitz bath with ozonised water after haemorrhoidectomy

Background

Haemorrhoidectomy - surgical removal of haemorrhoids - is effective, but recovery is often dominated by significant perianal pain and a slow-healing open wound at the surgical site. Warm water sitz baths (sitting in a shallow basin of water to bathe the perianal area) are a long-standing part of post-operative care, thought to soothe pain and support wound cleanliness. Researchers in South Korea investigated whether adding ozone to the sitz bath water - creating ozonised (ozonated) water - could improve on plain tap water for controlling pain and accelerating wound healing after this procedure.

Study design

The study enrolled 80 patients aged between 18 and 65 who had undergone haemorrhoidectomy, randomly allocating them into two equal groups of 40. One group (Group O) took daily sitz baths using ozonised water, while the other (Group T) used ordinary tap water. Before the clinical comparison, the researchers first tested ozonised water at three concentrations - 1, 2 and 4 parts per million - to establish which concentration produced reliable bactericidal (germ-killing) activity, and used this to inform the water used in the trial. Pain was measured using the Visual Analogue Scale (VAS), a standard 0-10 self-reported pain rating tool, on post-operative days two, three and seven. The time taken for the surgical wound to fully heal was also recorded for each group.

Findings

By day seven after surgery, patients using ozonised water reported significantly lower pain scores than those using tap water (average VAS score 1.35 versus 2.40 out of 10, a statistically significant difference). Wound healing was also markedly faster in the ozonised water group, with complete healing of the surgical site taking an average of 2.75 weeks (around 19 days) compared with 3.85 weeks (around 27 days) in the tap water group - a difference of roughly a week, and again statistically significant.

What the authors concluded

The authors concluded that sitz baths using ozonised water were more effective than standard tap water sitz baths at reducing post-operative pain and speeding up wound healing following haemorrhoidectomy, and suggested it as a straightforward addition to routine post-surgical aftercare.

Limitations of this study

This was a single-centre study conducted in one hospital in South Korea with a moderate sample size of 80 patients, which limits how confidently the results can be generalised to other populations, surgical techniques or healthcare settings. Because patients and carers could likely tell which water was being used, the study does not appear to have been blinded, which can influence self-reported outcomes like pain scores. Follow-up was also relatively short, focused on the initial healing period rather than longer-term outcomes, and the practicalities and cost of producing ozonised water for home or clinical use were not addressed. Further, independently replicated trials across different centres and patient groups would help confirm these findings.