To analyze the efficacy of external application of Zihua Shengji Formula (Purple Flower Tissue Regeneration Formula) on postoperative wounds in anorectal surgery based on the theory of "Fostering exudate to promote tissue regeneration" Theory.

A total of 120 patients with low simple anal fistula/external haemorrhoid undergoing surgery in the Anorectal Department of Handan Hospital of Traditional Chinese Medicine from November 2023 to November 2024 were selected as the study subjects. Patients were numbered 1-120 according to their visit sequence and randomly divided into a control group (60 cases, receiving routine postoperative wound care with Western medicine) and a study group (60 cases, receiving routine postoperative wound care with Western medicine plus external application of Zihua Shengji Formula). The wound healing status, wound pain level, inflammatory cytokine levels in wound tissue, growth factor levels, and extracellular matrix (ECM) metabolism-related indicators were compared between the two groups.

Compared with the control group, the study group showed significantly higher wound healing rates on the 7^th and 14^th postoperative days, significantly lower Visual Analogue Scale (VAS) pain scores on the 7^th and 14^th postoperative days, and a significantly shorter wound healing time (P <0.05). Compared with levels on the 1st postoperative day within each group, the levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6 in wound tissue on the 14^th postoperative day decreased significantly in both groups, while IL-10 levels increased significantly. Furthermore, compared with the control group, the study group exhibited significantly lower levels of TNF-α, IL-1β, and IL-6, and significantly higher levels of IL-10 on the 14^th postoperative day (P < 0.05). Compared with levels on the 1st postoperative day within each group, the levels of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) in wound tissue on the 14^th postoperative day increased significantly in both groups. Additionally, compared with the control group, the study group showed significantly higher levels of PDGF, VEGF, and bFGF on the 14^th postoperative day (P < 0.05). Compared with levels on the 1st postoperative day within each group, the levels of matrix metalloproteinase-2 (MMP-2) in wound tissue on the 14^th postoperative day decreased significantly in both groups, while type I collagen (Col I) levels increased significantly. Moreover, compared with the control group, the study group had significantly lower levels of MMP-2 and significantly higher levels of Col I on the 14^th postoperative day (P < 0.05).

External application of Zihua Shengji Formula facilitates the reduction of postoperative pain and wound inflammation in anorectal surgery patients. It regulates the levels of wound growth factors and ECM metabolism-related indicators, promotes wound repair, and shortens wound healing time.