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01-02-2015 | Original Article

Platelet-Rich Fibrin Sealant as a Treatment for Complex Perianal Fistulas: A Multicentre Study

Authors: F. J. Pérez Lara, A. Moreno Serrano, J. Ulecia Moreno, J. Hernández Carmona, M. Ferrer Marquez, L. Romero Pérez, A. del Rey Moreno, H. Oliva Muñoz

Published in: Journal of Gastrointestinal Surgery | Issue 2/2015

Abstract

Introduction

The incidence of perianal fistulas is high, and this condition has a profoundly negative impact on patients’ quality of life. The problem is greater when the fistula tract is high because treatment is necessarily complex (limited surgery may lead to recurrence, while aggressive surgery is associated with higher rates of faecal incontinence). To achieve a balance between these two options, we suggest that complex fistulas should be treated by sealing the tract with platelet-rich fibrin. Our objective is to evaluate the medium- to long-term results obtained from the treatment of complex perianal fistulas by sealing with platelet-rich fibrin.

Material and Methods

Prospective longitudinal multicentre study involves three colorectal surgeons working at three hospitals. The study period was October 2010 to June 2013, during which a total of 60 patients were treated for complex fistulas. In all cases, the intervention consisted of curetting the fistula tract, sealing it with platelet-rich fibrin and closing the internal orifice. We evaluated the clinical outcomes (clinical examination and pelvic magnetic resonance (MRI)) and the quality of life results, both general (SF-36) and gastrointestinal (GIQLI questionnaire) in periodic reviews during consultation.

Result

The median follow-up period was 24 months (11–43 months), during which in 40 patients (66.66 %) the fistulas remained closed, with a zero rate of faecal incontinence. The results of the quality of life questionnaires are comparable (indeed, they are better in some items for the cured patients) to those of the reference population.

Conclusion

In our opinion, this procedure is safe and its results are promising in terms of clinical outcome and medium- to long-term quality of life.

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Title: Platelet-Rich Fibrin Sealant as a Treatment for Complex Perianal Fistulas: A Multicentre Study
Authors: F. J. Pérez Lara
A. Moreno Serrano
J. Ulecia Moreno
J. Hernández Carmona
M. Ferrer Marquez
L. Romero Pérez
A. del Rey Moreno
H. Oliva Muñoz
Publication date: 01-02-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2698-7

At a glance: The STEP trials

Springer Medicine

Platelet-Rich Fibrin Sealant as a Treatment for Complex Perianal Fistulas: A Multicentre Study

Abstract

Introduction

Material and Methods

Result

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Material and Methods

Result

Conclusion

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