C. Lay open fistual – Explanation
Low or simple fistulae like in this stem are usually “laid open” by cutting a small amount
of anal skin and muscle to open the tract. Chronic granulation tissue is removed and
the tract is left open to allow it to heal spontaneously. It is usually packed on a daily
basis until the wound starts to heal from inside out.
of anal skin and muscle to open the tract. Chronic granulation tissue is removed and
the tract is left open to allow it to heal spontaneously. It is usually packed on a daily
basis until the wound starts to heal from inside out.
High or complex fistulae cannot be “laid open” because it involves cutting too much
muscle and could result in faecal incontinence.
Remember, lay-open management cannot be used for fistulae that cross the entire
internal and external sphincters as it will result in faecal incontinence. A submucosal
fistulae is considered a low fistulae and can be treated with lay open method
Anal fistula after surgical treatment
Other methods of treatment involve antibiotics but antibiotics cannot treat the underlying
fistula. It can only reduce symptom from recurrent sepsis.
