title: Split-shot sinker facilitates seton treatment of anal fistulae.
abstract: OBJECTIVE
  The cutting seton is an inexpensive and effective method of treating high complex perianal fistulae. Following placement of the seton, advancement through the external sphincter muscles requires progressive tightening of the seton. The requirement for maintaining the appropriate tension and onset of perianal pressure necrosis are problems frequently encountered using this technique.
  
  
  METHODS
  Using a 3-0 polypropylene suture, a red-rubber catheter, and a nontoxic tin split-shot sinker, we minimized or eliminated these problems.
  
  
  RESULTS
  We initially used this technique in one patient with satisfactory results.
  
  
  CONCLUSIONS
  This technique is technically easy, safe, inexpensive, and efficient, and we are using it in all patients with high perianal fistulae who require a seton.
authors.affiliation: UPMC Mercy Hospital, Pittsburgh, Pennsylvania 15219, USA. mlawad@neoucom.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Awad
authors.forename: H W
authors.initials: HW
authors.lastname: Sell
authors.forename: K R
authors.initials: KR
authors.lastname: Stahlfeld
mesh_terms: D005260:Female; D006801:Humans; D012003:Rectal Fistula / Q000601:surgery*; D013525:Surgical Instruments; D053441:Suture Anchors; D013536:Suture Techniques