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This combination therapy, evaluated by Al-Kindy College of Medicine, consists of autologous platelet-rich plasma (PRP) injections and topical nitroglycerin ointment for the treatment of chronic anal fissures. PRP is a concentrated source of autologous platelets that, upon activation, release various growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β). These factors stimulate tissue regeneration, angiogenesis, and wound healing at the fissure site. Nitroglycerin acts as a nitric oxide donor, which promotes the relaxation of the internal anal sphincter, thereby reducing anal hypertonicity and improving local blood flow to facilitate healing.
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