Effectiveness of Combined Mucosal Advancement Flap with Autologous Platelet-Rich Plasma in the Management of Complex Anal Fistula: A Pilot Randomized Controlled Trial

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

10.21608/ejsur.2025.345685.1318

Abstract

Background: The management of complex anal fistulas often requires advanced techniques, especially when a
considerable portion of the anal sphincter is involved. Platelet-rich plasma (PRP) has emerged as a talented adjunctive
therapy, enhancing healing rates and reducing recurrence when combined with mucosal advancement flap (MAF) surgery.
Patients and Methods: This study evaluated the effectiveness of MAF with and without locally applied PRP in patients
with complex anal fistulas. Primary outcomes included healing rate, with secondary outcomes assessing pain, continence,
and quality of life (QoL).
Results: This pilot randomized-controlled trial involved 82 patients with comparable demographics and fistula
characteristics across groups. PRP significantly reduced healing time (4.2 vs. 4.5 weeks, P= 0.0081) and improved
postoperative QoL scores at 1, 3, and 6 months. While initial postoperative pain levels were similar, PRP led to complete
pain resolution by 3 months (P= 0.0359). Complication and recurrence rates were comparable between groups, with
minor wound infections and incontinence resolving in most cases.
Conclusion: The findings indicate that locally applied PRP significantly accelerates healing and enhances QoL for
patients undergoing MAF for complex anal fistulas. Although recurrence and complication rates were similar, PRP seems
to be a safe and effective adjunctive therapy.

Keywords

Files

Share

How to cite

Statistics