Tisseel and anal fistula










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Other treatment modalities used less frequently include fibrin glue and ayurvedic drugs incorporated into setons. None of the three modifications were more successful than historic controls at our institution treated with sealant alone. In addition, patients were randomized to receive intra-adhesive cefoxitin, surgical closure of the primary opening, or both modifications. There are very few randomized controlled trials comparing the various modalities of surgery for fistula in ano. The quality of included studies was adequate, though in some trials the numbers were small and they were inadequately powered for equivalence or to detect significant differences. Median duration of fistulas was 12 months.

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Fibrin Glue For Anal Fistulas

Comparisons were made between various modalities of treatments. Therefore, the addition of intra-adhesive cefoxitin, closure of the internal opening, or both are not recommended modifications of the fibrin sealant procedure. Failures can be caused by persistent infection within the tract or early expulsion of the clot. It was also noted that Fibrin glue and advancement flap procedures report low incontinence rates. Non randomised trials and cohort studies were examined where data on recurrence and function were available. Randomised controlled trials comparing operative procedures for anorectal fistulae were considered.

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Fibrin glue for all anal fistulas

Therefore, the addition of intra-adhesive cefoxitin, closure of the internal opening, or both are not recommended modifications of the fibrin sealant procedure. For the appropriate patients, the primary fistula opening was closed with a absorbable suture. The use of Fibrin glue and advancement flaps are associated with low incontinence rates. In an attempt to improve the success rate, we examined three modifications of the sealant procedure. A prospective, randomized, clinical trial was performed in which patients were treated with Tisseel-VH fibrin sealant according to previously published procedures. None of the three modifications were more successful than historic controls at our institution treated with sealant alone.

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Description: Median duration of fistulas was 12 months. Non randomised trials and cohort studies were examined where data on recurrence and function were available. There were no significant difference in recurrence rates or incontinence rates in any of the studied comparisons except in the case of advancement flaps. The optimal surgical treatment for anorectal fistulae is associated with low recurrence rates, minimal incontinence and a good quality of life. There are very few randomized controlled trials comparing the various modalities of surgery for fistula in ano. However the trials on fibrin glue, as well as data from non randomised trials show that incontinence is less, probably as there is no surgical disruption of the anal muscle. The reviewers identified 10 trials that compare various fistula treatments against one another.
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