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Plugging a gap in the treatment options for perianal Crohn’s disease ▸

The management of perianal Crohn’s disease remains complex and often unsuccessful. Simple superficial fistulae may be treated with surgical lay open or fistulotomy, but these represent a minority, and more complex procedures such as advancement flaps are associated with a failure rate as high as 75%. A multidisciplinary approach with insertion of draining setons followed by biological treatment will dry up 50% of fistulae in the short term and yet, despite all of this, proctectomy is ultimately required in 12–20% of patients with Crohn’s fistulae.

The Surgisis anal fistula plug (Cook Surgical Inc, Bloomington, Indiana, USA), is a bioabsorbable xenograft, made of lyophilised porcine intestinal submucosa. The material has inherent resistance to infection, produces no foreign body or giant cell reaction and becomes repopulated with host cell tissue over a period of 3–6 months. It is manufactured as a ”rat-tail” shaped material that is very simply inserted through the primary fistula tract at operation. …

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