Platelet-rich fibrin matrix as treatment for complex anal fistulae: A 3-year experience at a tertiary centre.
Lusilla Lopez, Alejandro LU
; Fält, Ursula
LU
; Buchwald, Pamela
LU
; Johnson, Louis Banka
LU
and Grip, Olof
LU
(2026)
In Colorectal Disease
28(4).
p.1-8
- Abstract
- Aim
Treatment of complex anal fistulae remains a significant challenge for physicians and patients. A sphincter-preserving technique with bioactive platelet-rich fibrin matrix is one option. This three-year study aimed to evaluate the efficacy of bioactive platelet-rich fibrin matrix in treating complex anal fistulae.
Method
This retrospective study analysed data from 2019 to 2022 of patients diagnosed with complex anal fistulae treated with a platelet-rich fibrin matrix at a tertiary centre. Endoanal ultrasound was used to morphologically characterize fistulas using Park's classification. Pearson's chi-squared and Kaplan–Meier (log-rank) analyses were used to evaluate between-group differences.
Results
A... (More) - Aim
Treatment of complex anal fistulae remains a significant challenge for physicians and patients. A sphincter-preserving technique with bioactive platelet-rich fibrin matrix is one option. This three-year study aimed to evaluate the efficacy of bioactive platelet-rich fibrin matrix in treating complex anal fistulae.
Method
This retrospective study analysed data from 2019 to 2022 of patients diagnosed with complex anal fistulae treated with a platelet-rich fibrin matrix at a tertiary centre. Endoanal ultrasound was used to morphologically characterize fistulas using Park's classification. Pearson's chi-squared and Kaplan–Meier (log-rank) analyses were used to evaluate between-group differences.
Results
A total of 213 patients were included in the study (181 with cryptoglandular fistulae and 32 with Crohn's disease-associated fistulae) with a median follow-up of 6.6 months (range 0.5–67.1 months). Cavities and secondary tracts were identified in 14.6% and 34.7% of the patients, respectively. External opening closure occurred in 32% after one procedure and 43% cumulatively after a second intervention. Healing rates did not differ statistically by aetiology or fistula location. Cavities and secondary tracts were associated with failure. During follow-up, 23% of the secondary tracts healed, whereas cavities derived no significant benefit from the intervention. No serious complications were reported.
Conclusion
Platelet-rich fibrin matrix is a simple and safe sphincter-preserving technique that achieves reasonably good results in the treatment of cryptoglandular and Crohn's disease-associated fistulae. While secondary tracts may respond well, further research is required to optimize the management of fistulae associated with cavities. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/e4b26e8a-64d2-4140-bcfc-20eedce550ac
- author
- Lusilla Lopez, Alejandro
LU
; Fält, Ursula
LU
; Buchwald, Pamela
LU
; Johnson, Louis Banka
LU
and Grip, Olof
LU
- organization
- publishing date
- 2026-04
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Colorectal Disease
- volume
- 28
- issue
- 4
- article number
- e70447
- pages
- 1 - 8
- publisher
- John Wiley & Sons Inc.
- ISSN
- 1462-8910
- DOI
- 10.1111/codi.70447
- project
- Utfall av behandling av komplicerade analfistlar med autologt fibrinrikt vävnadsklister (Obsidian® RFT)
- Treatment of complex anal fistulas
- Utredning och behandling av analfistlar: kliniska och hälsoekonomiska aspekter
- language
- English
- LU publication?
- yes
- id
- e4b26e8a-64d2-4140-bcfc-20eedce550ac
- date added to LUP
- 2026-04-08 12:32:51
- date last changed
- 2026-04-08 14:09:21
@article{e4b26e8a-64d2-4140-bcfc-20eedce550ac,
abstract = {{Aim<br/>Treatment of complex anal fistulae remains a significant challenge for physicians and patients. A sphincter-preserving technique with bioactive platelet-rich fibrin matrix is one option. This three-year study aimed to evaluate the efficacy of bioactive platelet-rich fibrin matrix in treating complex anal fistulae.<br/><br/>Method<br/>This retrospective study analysed data from 2019 to 2022 of patients diagnosed with complex anal fistulae treated with a platelet-rich fibrin matrix at a tertiary centre. Endoanal ultrasound was used to morphologically characterize fistulas using Park's classification. Pearson's chi-squared and Kaplan–Meier (log-rank) analyses were used to evaluate between-group differences.<br/><br/>Results<br/>A total of 213 patients were included in the study (181 with cryptoglandular fistulae and 32 with Crohn's disease-associated fistulae) with a median follow-up of 6.6 months (range 0.5–67.1 months). Cavities and secondary tracts were identified in 14.6% and 34.7% of the patients, respectively. External opening closure occurred in 32% after one procedure and 43% cumulatively after a second intervention. Healing rates did not differ statistically by aetiology or fistula location. Cavities and secondary tracts were associated with failure. During follow-up, 23% of the secondary tracts healed, whereas cavities derived no significant benefit from the intervention. No serious complications were reported.<br/><br/>Conclusion<br/>Platelet-rich fibrin matrix is a simple and safe sphincter-preserving technique that achieves reasonably good results in the treatment of cryptoglandular and Crohn's disease-associated fistulae. While secondary tracts may respond well, further research is required to optimize the management of fistulae associated with cavities.}},
author = {{Lusilla Lopez, Alejandro and Fält, Ursula and Buchwald, Pamela and Johnson, Louis Banka and Grip, Olof}},
issn = {{1462-8910}},
language = {{eng}},
number = {{4}},
pages = {{1--8}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Colorectal Disease}},
title = {{Platelet-rich fibrin matrix as treatment for complex anal fistulae: A 3-year experience at a tertiary centre.}},
url = {{http://dx.doi.org/10.1111/codi.70447}},
doi = {{10.1111/codi.70447}},
volume = {{28}},
year = {{2026}},
}