Rectovaginal fistula repair utilizing a cadaveric dermal allograft

Rectovaginal fistula repair is commonly performed through the vagina. When recurrent fistulae occur, healthy tissue such as a muscle or fat pad may be interposed to facilitate healing and prevent recurrence. A woman developed a postpartum rectovaginal fistula after her third-degree perineal laceration failed to heal completely. Two subsequent fistula repairs were performed, with recurrence following each procedure. The fistula was ultimately repaired by performing a layered closure and interposing a cadaveric dermal allograft between the rectovaginal septum and vaginal epithelium. Allogenic cadaveric graft may be a viable alternative to traditional autologous flaps for the repair of recurrent or complicated rectovaginal fistulae.