Plasmax™: Anus/Rectum
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Abel ME, Chiu YS, Russell TR, Volpe PA. Autologous fibrin glue in the treatment of rectovaginal and complex fistulas. Dis Colon Rectum 1993;36(5):447-9.
Summary: Autologous fibrin glue was used to treat 10 patients with complex or rectovaginal fistulas. Complete healing was reported in 60% of patients, including 4/5 (80%) rectovaginal fistulas.
Quotation: “The application of autologous fibrin glue offers an alternative or adjunctive therapy for the treatment of recurrent rectovaginal and complex abscess fistulas.”
Cintron JR, Park JJ, Orsay CP, Pearl RK, Nelson RL, Abcarian H. Repair of fistulas-inano using autologous fibrin tissue adhesive. Dis Colon rectum 1999;42(5):607-13.
Summary: Autologous fibrin adhesive created by ethanol precipitation was used to treat anal fistulas in 26 patients. Successful initial closure was seen in 21/26 patients. Two of the five failures were treated a second time and one closed, bringing the overall success rate to 85% (22/26) with no evidence of infection or complications.
Quotation: “Fibrin glue treatment of anorectal fistulas offers a unique mode of management that is safe, simple, and easy for the surgeon to perform. By using autologous fibrin tissue adhesive the patient avoids the risk of anal incontinence and the discomfort of prolonged wound healing which may be associated with fistulotomy.”
Cintron JR, Park JJ, Orsay CP, Pearl RK, Nelson RL, Sone JH, Song R, Abcarian H. Repair of fistulas-in-ano using fibrin adhesive: long-term follow-up. Dis Colon Rectum 2000;43(7):944-949.
Summary: Autologous fibrin adhesive was compared to commercial fibrin adhesive in a prospective clinical trial examining anal fistula closure in 79 patients. After one year, 54% of patients treated with autologous fibrin sealant had complete closure and 64% of patients treated with commercial fibrin sealant had complete closure.
Quotation: “The repair for fistulas-in-ano using fibrin glue injection offers a unique treatment modality, because sphincter muscles are not severed during this operation, nor are anatomic planes divided. Fibrin injection obliterates fistula tracts without cutting open or cutting out the fistula itself. With fibrin glue injection there is no risk of postoperative liquid fecal or gas incontinence. Therefore, even if a fistula recurs, the patient is left no worse than before.”
Okamoto K, Watanabe Y, Nakachi T, Kasuga T, Motohashi G, Chikaza G, Tasaki T, Watanabe M, Katano M, Goto Y, Uukata H, Nakada I, Sato S, Tabuchi T. The use of autologous fibrin glue for the treatment of a postoperative fecal fistula following an appendectomy: report of a case. Surg Today 2003;33(7):550-2.
Summary: Autologous fibrin glue was used to treat a recurrent fecal fistula in an 82-yearold man. After five months, no recurrence of the fistula had been reported.
Quotation: “In conclusion, autologous fibrin gluing for fecal fistula was found to be a safe, economical, and effective treatment.”
Sentovich SM. Fibrin glue for all anal fistulas. J Gastrointest Surg 2001;5(2)158-61.
Summary: Autologous fibrin glue or commercial fibrin sealant was used to treat anal fistulas in 20 patients, all of whom had a seton placed in the fistula tract six to eight weeks before, over a two-year period. The fistulas were successfully closed in 15 of 20 patients after a mean follow-up time of 10 months, with two more patients successfully treated with a second application, for a final success rate of 85%. No patients reported any change in continence after treatment.
Quotation: “We can say, however, that regardless of which technique or type of fibrin glue is used, fibrin glue does successfully close most anal fistulas with no reported complications. Thus fibrin glue closure can be used for all anal fistulas.”
Venkatesh KS, Ramanujam P. Fibrin glue application in treatment of recurrent anorectal fistulas. Dis Colon Rectum 1999;42(9):1136-9.
Summary: Thirty patients with recurrent anorectal, rectovaginal, or urethrovesicorectal fistulas were treated with autologous fibrin glue prepared from cryoprecipitate over a period of four years. The overall success rate was 60%, with no major complications reported. Fistulas attributed to AIDS and the urinary tract did not heal.
Quotation: “The application of fibrin glue is a good alternative treatment for recurrent anorectal fistulas. It is minimally invasive and free of complications without causing patients any significant discomfort, with a resumption of full activities within 24 hours in all patients.”