The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life.


AIM The use of a loose seton for complex anal fistulae can cause perianal discomfort and reduced quality of life. The aim of this study was to assess the impact of the novel knot-free Comfort Drain on quality of life, perianal comfort and faecal continence compared to conventional loose setons. METHOD Forty-four patients treated for complex anal fistula at a single institution between July 2013 and September 2014 were included in the study. A matched-pair analysis was performed to compare patients with a knot-free Comfort Drain and controls who were managed by conventional knotted setons. The 12-item Short Form survey (SF-12) questionnaire was used to assess quality of life. Additionally, patients reported perianal comfort and faecal incontinence using a Visual Analog Scale (VAS) and the St Mark's Incontinence Score. RESULTS The Comfort Drain was associated with improved quality of life with significant higher median physical (P = 0.001) and mental (P = 0.04) health scores compared with a conventional loose seton. According to the VAS, patients with a Comfort Drain in situ reported greater perianal comfort with significantly less burning sensation (P < 0.001) and pruritus (P < 0.001). Faecal continence was similar in each group. CONCLUSION The Comfort Drain offers improved perianal comfort and better quality of life compared with a conventional loose seton and therefore facilitates long-term therapy in patients with complex fistula-in-ano.

DOI: 10.1111/codi.13335


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@article{Kristo2016TheTO, title={The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life.}, author={Ivan Kristo and Anton Stift and Cecil L Staud and A. Kainz and Thomas Bachleitner-Hofmann and Praminthra Chitsabesan and Stefan Riss}, journal={Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland}, year={2016}, volume={18 6}, pages={O194-8} }