Xenogeneic collagen has been demonstrated to aid soft tissue reinforcement. In this study, in contrast to published data relating to the use of conventional synthetic mesh, there were no complications related to infection or the implant's proximity to the bowel. This trial demonstrates that the implant is safe, feasible to use and has the potential to prevent parastomal herniation.
The collagen implant demonstrated excellent biocompatibility and resistance to degradation in most patients. However, fibrovascular in-growth and ECM deposition were limited. This implant has excellent potential for soft tissue reinforcement.
This 'straight to test' pilot study suggests a potential strategy for reducing the time to diagnosis and therefore first treatment of those identified with CRC, and offers a methodology for individual hospitals to assess their suitability to employ such a strategy.
Anal fistulas are chronic pathological connections between the anal canal and perineal skin. By either persistently discharging or intermittently occluding, causing recurrent abscess formation, they can significantly impact on the lives of those afflicted. Anal fistulas often pass through the anal sphincter complex, responsible for maintaining continence to rectal contents (gas, liquid or solid stool); therefore, treatment is aimed not only at fistula eradication but also at preserving sphincteric function. To date, fistulotomy remains the most effective way of eradicating the pathology, but division of those sphincter muscle fibres enclosed by the tract renders the patient at risk of incontinence. For those in whom fistulotomy is not recommended, alternative strategies exist, including techniques aimed at minimizing sphincter disruption, ′sphincter−conserving′ methods or the placement of a long−term loose draining seton. This article reviews the literature on all aspects of anal fistulas, and hopefully provides the reader with an insight to their potential complexity, the consequent difficulties in their management and the requirements of postoperative care.
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