ENTANGLED DRESSING MATERIAL CAN LEAD TO ANAL FISTULA RECURRENCE

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DISCLAIMER- MEDICAL EDUCATIONAL VIDEO. NOT TO PROMOTE SEXUALITY OR NUDITY.

Recurrent anal fistulas: When, why, and how to manage?
Anal fistula is a commonly encountered anal condition in the surgical practice. Despite being a benign condition, anal fistula remains to represent a surgical challenge, particularly the complex type of fistulas. One of the common complications of anal fistula surgery is the persistence or recurrence of the pathology, both defined as failure of surgery. Recurrent anal fistulas after previous surgery represent an even more challenging problem since they are usually associated with a higher risk of re-recurrence and continence disturbance.
Core tip: Recurrent anal fistulas represent a unique challenge to general and colorectal surgeons. They are usually associated with high risk of re-recurrence and fecal incontinence. The risk factors for recurrence of anal fistula after surgery include preoperative, intraoperative, and postoperative factors. Thorough assessment of recurrent anal fistulas is crucial before planning treatment. Endoanal ultrasonography and magnetic resonance imaging are the most widely used modalities for the assessment of recurrent anal fistulas. Treatment of recurrent anal fistula should address the cause of recurrence, extirpate the entire fistula tract, ensure adequate drainage of sepsis and at the same time preserve the anal sphincters and continence.
DEFINITIONS OF RECURRENCE
Success of anal fistula surgery is generally defined as complete healing of the anal wound by epithelization without residual tract, external or internal openings, or perianal discharge. On the other hand, failure of fistula surgery comprises three different definitions; persistence, recurrence, and de-novo fistula. Persistence of anal fistula is defined as failure of complete healing of the anal fistula for more than six months after surgery. Recurrence is defined as clinical reappearance of the fistula after complete healing of the surgical wound, occurring within one year after the procedure. Whereas de-novo fistula is the clinical appearance of fistula after complete healing of the surgical wound, occurring more than one year after the procedure.
Category
Urology
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