**12. Surgical treatment**

62 Complementary Pediatrics

Fig. 3d. Paeonia-Heel: a homeopathic medicine containing Paeonia officinalis (Peony), Graphites (graphite), Nux vomica (vomit nut), Sulfur (sulphur), Acidum nitricum (nitric

Fig. 3e. Dr Wheatgrass's cream: enriched with highly bioactive wheatgrass-derived antioxidants, containing vitamins A,C and E, phytosterols, aminoacids and minerals. The

Fig. 3f. Nature's Wonderland Stone Root Herbal Supplement: Collinsonia Canadensis, sour

and spicy in taste, and warming in action. It relaxes constriction and clears venous congestion and inflammation. The Figure shows the Collinsonia Canadensis flowers.

Figure shows Dr Wheatgrass's antioxidant skin recovery cream.

acid), and Hamamelis (witch-hazel).

Surgical treatment is rarely needed for infants and children. Open or closed lateral internal sphincterotomy (healing rates of 93% to 100%, recurrence rates of 0% to 25%), internal sphincterotomy (for chronic anal fissures), and posterior midline sphincterotomy are all part of the surgical arsenal. The open lateral sphincterotomy is the procedure of choice for children. Relative contraindications to operative treatment include inflammatory bowel disease and profound immunosupression.
