Negative Pressure Wound Therapy for Complex Perianal Fistulas: A Case Series

Area of Science:

• Colorectal Surgery
• Wound Healing
• Medical Devices

Background:

• Complex perianal fistulas present significant treatment challenges, often leading to high recurrence rates.
• Preserving sphincter function is crucial during surgical interventions for perianal fistulas.
• The role of Negative Pressure Wound Therapy (NPWT) in managing perianal fistula surgery requires further definition.

Purpose of the Study:

• To evaluate the feasibility, safety, and early clinical outcomes of NPWT in patients with complex perianal fistulas post-surgical excision.
• To assess the efficacy of NPWT in promoting wound healing and symptom resolution in this patient cohort.

Main Methods:

• A retrospective case series involving eight adult patients with complex cryptoglandular perianal fistulas.
• Surgical debridement of fistula tracts followed by the application of portable NPWT.
• Assessment of outcomes including time to epithelialisation, symptom resolution, recurrence, complications, and NPWT-related technical aspects.

Main Results:

• Seven out of eight patients achieved complete epithelialisation of the perianal wound with NPWT.
• One patient experienced recurrence requiring ongoing seton drainage.
• Optimisation of NPWT dressing techniques improved reliability and wound healing progression without device-related adverse events.

Conclusions:

• NPWT is a feasible and well-tolerated adjunct therapy for complex perianal fistulas following surgical debridement.
• The therapy demonstrated high early healing rates and no device complications in this small series.
• Larger prospective studies are recommended to confirm efficacy and establish optimal NPWT parameters for perianal fistula management.