Effectiveness of Autologous Platelet Rich Plasma in the Treatment of Hight Perianal Fistula.

Abstract

high perianal fistula, platelet rich plasma. Background: The main issue involves high perianal fistula management, as fistulotomy would represent an inacceptable risk of incontinence in such patients. Platelet rich plasma (PRP) is defined as a portion of patient own plasma with high concentration platelet and growth factor levels as obtained by centrifugation. Platelets have alpha granules that contain several proteins with multiple actions on the various aspects of tissue repair. Aim of the study was to evaluate the use of autologous platelet rich plasma in the treatment of perianal fistula. Methods: A prospective study including patients with high perianal fistula who presented to General Surgery Department of Zagazig University in the period from September 2016 to February 2019. Result: We had 16 patients with a diagnosis of high perianal fistula, 9 males and 7 females. We had a clinical success rate of 75% (12 patients out of 16 were completely healed with no recurrence throughout the follow up period). Two patients (12.5%) developed postoperative abscess formation and another two patients (12.5%) showed persistent external opening. Conclusion: Platelet rich plasma is promising in the treatment of high perianal fistula without affection of fecal continence.

Evaluation of Fistulotomy with Immediate Sphincteric Reconstruction in the Treatment of High Transsphincteric Perianal Fistula

“…However, technical procedures in the treatment of anal fistulae include placement of a seton, fibrin glues, platelet-rich plasma, plugs, and an endorectal flap are used. 2,3 In 1985, Parkash et al 4 published their results on primary closure and reconstruction after fistulotomy, an approach intended mainly to reduce the healing time and to prevent postoperative anal deformity. Since then, fistulotomy with primary sphincteroplasty has been adopted also for complex anal fistulas, to obtain low recurrence rates without compromising continence as the lay-open technique does.…”