Evidence - Anal fistula, closure with Anal Fistula Plug® (AFP®)

Originating from the USA, the Anal Fistula Plug® was introduced in Germany in 2006. Using a narrow cylinder made from porcine collagen, the fistula tract is occluded from the inside. Unlike other surgical techniques, extensive removal of fistula tissue is avoided, simplifying the operation and resulting in only small postoperative wounds. Initially, very enthusiastic reports claimed healing rates of over 85%, but randomized studies have only achieved healing rates of 20-30%. Therefore, the plug is now used only in a few cases as one of several options for high fistulas.