Anal Fistula...
Q. How is Fibrin glue treatment done
and what are disadvantages of this procedure?
Fibrin glue is made from plasma protein
which is used to seal up and heal the fistula tract rather than cutting it open.
In this procedure, the tract is cleared after which the internal opening is
stitched closed and the glue is injected through the external opening. The glue
is of 2 types-Autologous or Commercial prepared fibrin sealantADVANTAGES
·
Non-invasive,
little pain, early recovery, less morbidity,
·
Can
be used again after a failure
·
Simple
procedure
·
NO
RISK of Incontinence
·
Success
rates ranging from 31-80% in different studies
·
Good in long, complex fistulas and Crohn’s disease
DISADVANTAGES
·
Healing
rates decreases as the follow up time increases- Initially most of the fistulas
closes but after >2 years follow up, success rates drop to 31%
·
Ineffective
in short, wide tracts esp. recto-vaginal fistulas
·
Inability
to close internal opening securely over a ‘liquid’ glue
·
High
Cost
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