Long-term Outcomes of Human Acellular Dermal Matrix Plug in Closure of Complex Anal Fistulas With a Single Tract

Abstract

Given the low morbidity and relative simplicity of the procedure, we suggest that an acellular dermal matrix plug is a reasonable option for closure of complex anal fistulas with a single tract.

Repair of a cervical skin defect using xenogeneic acellular dermal matrix in a patient with advanced laryngeal carcinoma

“…[3][4][5] Repair of the skin defect following wide resection of an advanced laryngeal carcinoma always necessitates flap reconstruction. Its use and clinical outcomes are well documented.…”

Controversies in Fistula in Ano

“…Some studies have shown that longer tracts have better chances of closure [12]. Results with bioprosthetic plugs have shown higher results varying from 54 % to 72 %, although the test series have been very small [13][14][15].…”

Bioabsorbable Synthetic Plug in the Treatment of Anal Fistulas

“…one of the principal causes of treatment failure is plug migration or extrusion, 1,21 which has been reported to occur in 4% to 41% of cases. 20 Plug dislodgment has also been problematic in the 2 studies of other "biological" fistula plugs (ie, devices made of human or porcine acellular dermal matrix) that have been published, with the reported rates being 21% 22 and 11%. 23 Because of these disappointing outcomes, the need remains for an effective, minimally invasive, sphincter-sparing therapy for anal fistulas.…”