Comparison between application of platelet rich plasma and mucosal advancement flap in patients with high transsphincteric anal fistulas: a randomized control trial

Background There is still a search for a standard method of therapy for high anal fistulas. The aim of this trial was a comparison between a modified two stage minimally invasive procedure, consisting of loose‐seton placement with the subsequent application of platelet rich plasma with mucosal advan...

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Bibliographic Details
Published in:ANZ journal of surgery 2022-05, Vol.92 (5), p.1137-1141
Main Authors: Hermann, Jacek, Cwaliński, Jarosław, Banasiewicz, Tomasz, Kołodziejczak, Barbara
Format: Article
Language:English
Subjects:
anal fistula
Connective Tissue Diseases
Curettage
Fistula
Humans
Morbidity
Mucosa
mucosal advancement flap
Patients
Placement
Platelet-Rich Plasma
Platelets
Prospective Studies
Rectal Fistula - surgery
Statistical analysis
Surgical Flaps
Treatment Outcome
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Summary:Background There is still a search for a standard method of therapy for high anal fistulas. The aim of this trial was a comparison between a modified two stage minimally invasive procedure, consisting of loose‐seton placement with the subsequent application of platelet rich plasma with mucosal advancement flap for the treatment of high transsphincteric anal fistulas of crypto‐glandular origin. Methods The study was designed as a prospective, randomized trial including 96 patients. Curettage of fistulous tracts, and loose‐seton placement was performed in those patients with active inflammation, and if the diameter of a fistulous tract exceeded 3 mm. Afterwards, the patients were randomly assigned to either the PRP group or MAF group, consisting of 49 patients, and 47 patients, respectively. Results There was no significant statistical difference (p = 0.152) between both investigated groups of patients regarding closure of fistulas since it was achieved in 35 (71.43%) patients from group I, compared to 27 (57.45%) patients from group II. The diameter of fistulous tracts below 4 mm exerted a significant impact (p 
ISSN:1445-1433
1445-2197
DOI:10.1111/ans.17656