Repair of fistula in ANO: is primary closure worth?

ABSTRACT

To determine the efficacy of primary closure of wound after fistulectomy in anal fis-tulae patients as a method of successful treatment to reduce the time of healing and hospital stay with special reference to recurrence and continence. Descriptive, retrospective study from 1995 to 2005. Sindh Government Qatar Hospital Orangi Town Karachi and author's private clinic, Medlyn Hospital Block H North Nazimabad Karachi. 300 patients who presented with low anal fistula [Park's classification I and II] during the above-mentioned period. The data of all 300 patients were analyzed as regards to presentation, treatment, and the outcome. A total of 300 patients with low fistula in ano were treated by primary closure. The postoperative complications were minimal and managed conservatively. The mean length of follow-up was 3 years. Recurrence took place in 3% patients. The average recovery time was 12 days. Similarly return to work is also early 14 days. Three patients were incontinent to flatus while 1 was incontinent to faeces and flatus for the first six months. It is observed that following fistulectomy and primary closure of low fistula in ano, sound healing can be achieved in over 97% of cases with amazingly early return to work