Vacuum-assisted closure of chronic anorectal fistula
Successful treatment of perianal fistulae requires drainage of underlying sepsis and definition and eradication of all primary and secondary tracts. The majority of patients with simple fistula-in-ano can be effectively treated by fistulotomy. Patients with chronic fistulae often have complex tracts and large abscess cavities that require multiple interventions in expert hands to achieve complete healing. Staged fistulotomy/fistulectomy with or without the use of a seton promotes progressive healing and fistula closure while preserving continence. Failure of fistula healing is frequently the result of unrecognised or incompletely treated sepsis in the deep postanal space.
We report the use of vacuum-assisted dressing in two patients with complex chronic anorectal fistulae of differing aetiology in which rapid, complete, and sustained healing was achieved.
In 1997, Argenta and Morykwas  were the first to describe the benefit of a vacuum-assisted closure (Kinetic...