Perianal fistulae are common in Crohn's disease but rarely heal without treatment. The main aim of treatment is to effectively close the fistula without affecting sphincter integrity and continence. Traditional surgical and medical approaches are not without their limitations and may result in either comorbidity, such as fecal incontinence, or incomplete healing of the fistulae. Over the last 2 decades these limitations have led to a paradigm shift toward the use of biomaterials, and more recently cell-based therapies, which have met with variable degrees of success. This review discusses the traditional and current methods of treatment, as well as emerging and possible alternative approaches that may improve fistula healing. Inflamm Bowel Dis 2009
1Biomaterials and Tissue Engineering Group, Centre for Gastroenterology & Nutrition, University College London, UK
*Reprints: Biomaterials and Tissue Engineering Group, Centre for Gastroenterology & Nutrition, Windeyer Institute, University College London, 46 Cleveland St., London, W1T 4JF, UK. e-mail: firstname.lastname@example.org
Received 14 September 2009; Accepted 14 September 2009
Supported by European Crohn's and Colitis Organization (ECCO); Medical Research Council; Sir Halley Stewart Trust; Department of Health's NIHR Comprehensive Biomedical Research Centres funding scheme.
Published online 15 October 2009 in Wiley InterScience (www.interscience.wiley.com).