title: Evaluating the use of fibrin glue for sealing low-output enterocutaneous fistulas: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  The management of an enterocutaneous fistula poses a significant challenge to surgeons and is often associated with a costly hospital stay and long-term discomfort. The use of fibrin glue in the fistula tract has been shown to promote closure of low output enterocutaneous fistulas. Our previous nonrandomized study demonstrated that autologous platelet-rich fibrin glue treatment significantly decreased time to fistula closure and promoted closure rates. However, there are several limitations in the study, which may lead to bias in our conclusion. Thus, a multicenter, randomized, controlled clinical trial is required.
  
  
  METHODS
  The study is designed as a randomized, open-label, three-arm, multicenter study in nine Chinese academic hospitals for evaluating the efficacy and safety of fibrin glue for sealing low-output fistulas. An established number of 171 fistula patients will undergo prospective random assignment to autologous fibrin glue, commercial porcine fibrin sealants or drainage cessation (1:1:1). The primary endpoint is fistula closure time (defined as the interval between the day of enrollment and day of fistula closure) during the 14-day treatment period.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to evaluate the safety and efficacy of both autologous and commercial fibrin glue sealing for patients with low-output volume fistulas.
  
  
  BACKGROUND
  NCT01828892 . Registration date: April 2013.
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China. xiuwenwoo@gmail.com.
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China. JiananR@gmail.com.
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China. wgfwang@gmail.com.
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of General Surgery, The 1st Affiliated Hospital of Gannan Medical College, Ganzhou, China. surgeonwjz@163.com.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of General Surgery, The Affiliated Hospital of Neimenggu Medical University, Huhehaote, China. winer_77@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Chinese Medical University Aviation Hospital, Beijing, China. fanyp900164@sina.com.
authors.forename: Yueping
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of General Surgery, The 309th Hospital of The Chinese People's Liberation Army, Beijing, China. liyuanxin1966@163.com.
authors.forename: Yuanxin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Surgery, The Second Hospital of Jilin University, Changchun, China. gmail1973@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of General Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, China. shougencao@gmail.com.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Henan Province People's Hospital, Zhengzhou, China. xiaofei81920@163.com.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou, China. surgeonzhao@163.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Quan
authors.affiliation: Department of Surgery, VA Medical Center, 830 Chalkstone Avenue, Providence, USA. minyao99@hotmail.com.
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China. jieshou_li@163.com.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D002681:China; D002985:Clinical Protocols; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000628:therapy*; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D012107:Research Design; D013997:Time Factors; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives