Application of biomaterials for complex anal fistulae

Abstract

Complex anal fistulae remain a challenge for the medical sector as conventional treatments put patients at risk of incontinence. Clinicians and researchers have become interested in the application of bioresorbable materials, as a means of avoiding invasive procedures and/or secondary procedures. Advances in polymer chemistry and processing techniques, the range of biomaterial medical devices has expanded since first implemented in the early 1990’s. Clinical evaluation of biomaterial-based medical devices initially generated great enthusiasm, however; subsequent studies observed low – moderate success rates. The next generation of biomaterial-based devices focus on addressing the principles of fistulae treatment, these include: novel device design and the incorporation of bioactives and biologics. This review focuses on the biomaterials utilized, the form of medical device developed and the recent inclusion of dual-purpose scaffolds for complex anal fistulae treatments.