Anal fistula plug in high fistula-in-ano: Best Pract Res Clin Gastroenterol. A more complicated fistula, such as a horseshoe fistula where the tract extends around both sides of the body and has external openings on both sides of the anusis treated by usually laying open just the segment where the tracts join and the remainder of the tracts are removed. Cleveland Clinic is a non-profit academic medical center. The plug is drawn snug at the internal opening and sutured in place, and then cut flush at the external opening without fixation at this location[ 19 ]. This procedure is used for fistulas that form between the internal and external sphincters. However, the plug could be used if deemed appropriate in settings of intersphincteric and extrasphincteric fistulas.
Antibiotics reduce drainage from fistulas.
Fistulas can be simple single tunnel or complex multiple tunnels. Recto-vaginal fistulas may be secondary to Crohn's disease, obstetric injuries due to birth, radiation therapy or cancer. Most of the studies on bioprosthetic plugs focus on plugs made of treated porcine submucosa; however, newer synthetic plugs have recently come onto the market. The treatment of anal fistula has challenged physicians and healers for millennia. The tubular structure of an anal fistula easily yields itself to division or unroofing fistulotomy or excision fistulectomy in most cases.