The Role of Fibrin Glue in the Management of Fistula-in-Ano

Traditional surgical management of fistula-in-ano can sometimes risk continence. Fibrin glue has been proposed as a sphincter-conserving treatment for fistula-in-ano over the past two decades. Early results seemed promising; however, longer term follow-up was not as encouraging and opinions vary regarding its current place in fistula surgery. This article explains the mode of action of fibrin glue, reviews the current literature, and highlights the varied opinions and potential reasons for its lower long-term success rates. It also introduces the fistula plug, which has demonstrated fistula healing in recent reports.