The study compared outcomes of autologous platelet-rich plasma and loose Seton insertion in
treating high perianal fistulas and demonstrated the effectiveness and safety.
This was conducted from October 2017 to February 2023 as a prospective randomized controlled
clinical trial for patients suffering from high perianal fistula managed in department of
surgery, Suez Canal Hospitals and department of surgery, Armed Forces Military Hospitals. A
total of 102 patients were divided into two groups of 51 patients each. GA was treated by Loose
Seton insertion and GB was treated by applying Autologous Platelet Rich Plasma (APRP) into
fistulous track. Patients were assessed with clinical examination, MRI fistulogram, or endo-anal
U/S on follow-up if needed. Patients were followed every two weeks and until six months postoperatively.
The primary outcome measure was the fistula-healing rate (complete and nonhealing)
with secondary outcome measures assessing fistula recurrence, continence status, quality
of life, and pain scores.
The results showed that overall healed cases were 69/102 (67.6%) during follow up, which
was 37/51(72.5%) underwent Loose Seton insertion and 32/51(62.7%) for APRP injection with
little higher healing rate in loose Seton group, without significant differences (P 0.397).