Bioabsorbable Synthetic Plug in the Treatment of Anal Fistulas

Heydari, A; Attinà, Grazia Maria; Merolla, Enrico; Piccoli, Micaela; Fazlalizadeh, Reza; Melotti, Gianluigi

doi:10.1097/dcr.0b013e3182839824

Cited by 27 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Gore Bio-A fistula plug (Gore Medical, Flagstaff, AZ) is a synthetic bioabsorbable scaffold that acts in a manner similar to the Surgisis plug, but for a reportedly cheaper price, and with the addition of several "tentacles" that can be removed or adjusted in a fashion tailored to the size and number of fistula tracts. 60 Initial primary healing with this plug was reported at 69%, 61 but a subsequent multicenter case series reported a 12-month healing rate of 49%. 60 Overall, the AFP appears to be an acceptable approach to complex anal fistulas, as it is generally well tolerated with minimal side effects.…”

Section: Fistula Plugmentioning

confidence: 99%

Management of Complex Anal Fistulas

Bubbers

Cologne

2016

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

show abstract

Section: Fistula Plugmentioning

confidence: 99%

Management of Complex Anal Fistulas

Bubbers

Cologne

2016

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

show abstract

“…In their analysis of the success rates of biomaterial plugs in a homogeneous group of patients (trans-sphincteric fistulae with cryptic etiology), Heydri et al demonstrated a 69% efficacy rate in a 12-month follow-up period [10]. Similar results were obtained by Ratto et al who observed a success rate of more than 72% [11].…”

Section: Introductionmentioning

confidence: 60%

A novel model of acellular dermal matrix plug for anal fistula treatment. Report of a case and surgical consideration based on first utility in Poland

et al. 2017

View full text Add to dashboard Cite

Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from collagen material. We are presenting the first Polish experience with a new model of biomaterial plug for the treatment of anal fistula. We also point out key elements of the procedure (both preoperative and intraoperative) associated with this method. In the authors' opinion, the method is simple, safe and reproducible. Innovative shape of the plug minimizes the risk of its migration and rotation. It also perfectly blends with and adapts to the course and shape of the fistula canal, allowing it to become incorporated and overgrown with tissue in the fistula canal. The relatively short operation time, minor postoperative pain and faster convalescence are with no doubt additional advantages of the method. Long-term observation involving more patients is essential for evaluation of the efficacy of the treatment of fistulas with the new type of plug.

show abstract

“…The synthetic plug does not require rehydration before use. Heydari et al, 76 in their retrospective study on cryptoglandular, transsphincteric, and intersphincteric AF treated by bioabsorbable synthetic fistula plug, reported an overall healing rate at 12 months of 69.3% confirmed by ERUS. Among patients that healed, 24.2% had healed by 3 months, 63.6% by 6 months, and 12.1% by 12 months.…”

Section: Bioabsorbable Synthetic Fistula Plugmentioning

confidence: 98%

“…The polymer scaffold is replaced by a layer of new tissue that reinforces the repair. 76 The synthetic plug device consists of a PGA/TMC disk to which several narrow PGA/TMC tubes are attached. At the time of insertion, the plug can be tailored to fit and fill the specific fistula both by trimming the diameter of the disk and by removing one or more of the tubes.…”

Section: Bioabsorbable Synthetic Fistula Plugmentioning

confidence: 99%

Biomaterials in the Treatment of Anal Fistula: Hope or Hype?

Scoglio

Walker

Fichera

2014

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

). CME Objectives: After reading this article, the reader should be able to understand the role of biologic and synthetic materials for treatment of anal fistula.An anal fistula (AF) is an abnormal communication between the anal glands and the perianal skin. Reliable data on incidence of AF in the general population are not available, but in an epidemiologic study performed in four European countries (England, Germany, Italy, and Spain), the incidence reported was between 12 and 28 per 100,000. 1 The disease presents predominantly in the third and fourth decades of life 2 and it is more common in men than in women (12.3 vs. 5.6 per 100,000 cases). 1 According to the cryptoglandular hypothesis, intersphincteric gland infection is the initiating event in the formation of AF 3 and it usually develops in approximately one-third of patients who presents with a perirectal abscess. In a series 4 of 170 patients with no history of previous AF followed for an average of 99 months after abscess drainage, a fistula occurred in 37% and recurrent abscess was reported in an additional 10%. A retrospective cohort study 5 of 148 patients with anorectal abscesses showed again a 37% rate of fistula formation. Patients younger than 40 years had a higher likelihood of developing an AF during a mean follow-up of 38 months. Any recurrent abscess presenting at the same site should raise the suspicion of a fistula and be treated as such. There are several other causes of atypical/complicated abscess and fistula such as inflammatory bowel disease, fungal infection, mycobacterial infection, neoplasm, and trauma. Fistulas that are secondary to these processes are classified as complex and require the use of nonstandard methods of management.In 1976, Parks et al 6 classified AF in four different types according to their passage through the sphincteric planes: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric (►Table 1). The most common presentation is intersphincteric, followed by transsphincteric. The remaining types are relatively uncommon. This is the most widely used classification. 7 However, a more practical approach is based on whether the internal opening is high or low within the anal canal. Low transsphincteric fistulas involve the lower third of the external anal sphincter mechanism and are generally treated by fistulotomy with a high success rate for cure. High transsphincteric fistulas involving the upper two-thirds of the external sphincter remain a surgical challenge because incontinence may result from the division of muscle involving more than one-third of the sphincter. The basic principles in the treatment of anorectal abscess and AF include eradication of perineal sepsis, complete AbstractAnal fistula (AF) presents a chronic problem for patients and colorectal surgeons alike. Surgical treatment may result in impairment of continence and long-term risk of recurrence. Treatment options for AFs vary according to their location and complexity. The ideal approach should result in low recurrence rates...

show abstract

Bioabsorbable Synthetic Plug in the Treatment of Anal Fistulas

Abstract: In patients with cryptoglandular anal fistulas, the use of a bioabsorbable synthetic plug provided a high rate of healing without causing fecal incontinence or other major adverse effects. Larger and randomized studies of this treatment are warranted.

Cited by 27 publications

References 23 publications

Management of Complex Anal Fistulas

Management of Complex Anal Fistulas

A novel model of acellular dermal matrix plug for anal fistula treatment. Report of a case and surgical consideration based on first utility in Poland

Biomaterials in the Treatment of Anal Fistula: Hope or Hype?

Contact Info

Product

Resources

About