Outpatient placement of perforated setons prior to treatment of sealants for perianal fistula: A Technical Note

Abstract

The incidence of perianal fistulas is 1.1–2.2 cases per 10,000 people per year in the European population [1]. Numerous treatment options, which have a profoundly negative impact on patients' quality of life [2], have been developed for complex perianal fistulas, but none has achieved a success rate of over 80% [3]. In recent years, conservative techniques have emerged for the treatment of complex perianal fistulas. Since 2011, we have been using the platelet-rich fibrin sealing technique [4], and a review showed that results were better in patients who had previously had a seton inserted. However, this approach requires two interventional procedures—one for seton placement and another for sealing. To improve this, we have developed an outpatient technique for seton placement that does not require anaesthesia.