How is Fibrin glue treatment done and what are disadvantages of this procedure?

Fibrin glue is made from plasma protein which is used to seal up and heal the fistula tract rather than cutting it open. In this procedure, the tract is cleared after which the internal opening is stitched closed and the glue is injected through the external opening. The glue is of 2 types-Autologous or Commercial prepared fibrin sealant

ADVANTAGES

• Non-invasive, little pain, early recovery, less morbidity,
• Can be used again after a failure
• Simple procedure
• NO RISK of Incontinence
• Success rates ranging from 31-80% in different studies
• Good in long, complex fistulas and Crohn’s disease

DISADVANTAGES

• Healing rates decreases as the follow up time increases- Initially most of the fistulas closes but after >2 years follow up, success rates drop to 31%
• Ineffective in short, wide tracts esp. recto-vaginal fistulas
• Inability to close internal opening securely over a ‘liquid’ glue
• High Cost