title: Using autologous platelet-rich plasma for the treatment of complex fistulas.
abstract: OBJECTIVE
  This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas.
  
  
  METHODS
  Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2).
  
  
  RESULTS
  From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery.
  
  
  CONCLUSIONS
  This study demonstrates that there is a clear benefit to the use of Vivostat PRF® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.
authors: Cirugia General, Hospital La Inmaculada, España.
authors: Almudena
authors: A
authors: Moreno-Serrano
authors: Cirugia, Hospital Torrecárdenas, España.
authors: Juan José
authors: JJ
authors: García-Díaz
authors: Cirugía, Hospital Torrecárdenas, España.
authors: Manuel
authors: M
authors: Ferrer-Márquez
authors: Universidad de Almeria.
authors: Raquel
authors: R
authors: Alarcón-Rodríguez
authors: Cirugía, Hospital Torrecárdenas, España.
authors: Antonio
authors: A
authors: Álvarez-García
authors: Cirugia, Hospital Torrecárdenas, España.
authors: Ángel
authors: Á
authors: Reina-Duarte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001804:Blood Transfusion, Autologous; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D012003:Rectal Fistula / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D055815:Young Adult