A Composite Seton for the Management of Fistula in Ano

Abstract

Treatment of fistula in ano by seton has become less in vogue due to the complications and disadvantages associated with its use. In its place, more technically demanding and expensive procedures, with less morbidity but more recurrence, such as endorectal advancement flaps and laser, are being employed more commonly. To overcome some of the limitations of conventional seton, we have designed a composite seton. In the present study, we evaluated our experience with a composite seton made from two silastic vessel loops sutured together with 5-0 polypropylene. The composite seton was found to not present many of the disadvantages of the conventional seton. The use of the composite seton resulted in low incontinence and recurrence rates, less pain, and high quality of life. This technically simple and cheaper material may have a wider applicability.