Fistula Research Today is a free monthly online journal that collates and summarizes the latest research about Fistula, including details on types, causes, treatment.

Histologic analysis of acellular dermal matrix in the treatment of anal fistula in an animal model.

Han JG, Xu HM, Song WL, Jin ML, Gao JS, Wang ZJ, Yang XQ

Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, PR China.

BACKGROUND: Human acellular dermal matrix (ADM) has been used successfully for the treatment of severe burns, ureter support, and abdominal wall reconstruction. This study was designed to evaluate the mechanism of ADM in the closure of anal fistula in an experimental porcine model. STUDY DESIGN: The fistula-in-ano model was created in the porcine model and treated with ADM in 14 animals. Fistula specimens were obtained at hours 12 and 24 and on days 3, 7, 14, 28, 60. Hematoxylin and eosin staining, Masson trichrome staining, and immunohistochemical staining for alpha smooth muscle actin and matrix metalloproteinase 9 were performed. RESULTS: The cell density increased from hour 12 to day 7 and decreased from day 7 to day 28 (p < 0.001). Mature vessels stained with alpha smooth muscle actin were identified at day 7. Alpha smooth muscle actin-positive myofibroblasts were found in clusters at the edge of the ADM at day 7. The density of vessels (p < 0.001) and myofibroblasts (p < 0.001) increased from day 7 to day 14. The density of matrix metalloproteinase 9 increased from hour 12 to day 7 and decreased from day 14 to day 60 (p < 0.001). Partially organized bundles of muscle were found by day 60. CONCLUSIONS: We suggest that ADM is a reasonable new option for closure of anal fistulas. Anal fistulas begin to heal as early as 12 hours, and day 7 may be an important time point to judge whether the fistula healed preliminarily or not. The ability of ADM to become vascularized and remodeled by autologous cells may be advantageous for anal fistula healing.

Published 29 May 2009 in J Am Coll Surg, 208(6): 1099-106.
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Articles on Fistula published 22 May 2009:

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We treated a severe cervical fistula with a defect of tracheal cartilage using prefabrication of a corticoperiosteal flap combined with a cutaneous flap.The patient was a 16-year-old male with a cervical tracheal fistula that developed after a tracheostomy. Almost all the circumference of the trachea just below the cricoid cartilage up to the 4th tracheal cartilage had been lost.The reconstruction was performed in 2 series of operations as follows; repair of tracheal framework using a ... [Abstract] [Full-text]

Articles on Fistula published 5 May 2009:

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Articles on Fistula published 27 April 2009:

Anal fistula plug and fibrin glue versus conventional treatment in repair of complex anal fistulas.   Am J Surg, 197(5): 604-8.

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Articles on Fistula published 22 April 2009:

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Articles on Fistula published 21 April 2009:

Obliteration of empyema space by vascularized anterolateral thigh flaps.   Ann Thorac Surg, 87(5): 1615-6.

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