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Although excision of the fistula and fistulectomy was thought to be a satisfactory method of treatment of fistula-in-ano, its use is no longer recommended. Large wounds are created by significantly prolonging wound healing time.61 a greater separation of the muscle ends occurs1 and there is greater risk of injury or excision muscle57 underlying, increasing the risk of incontinence. Schouten and van Vroonhoven14 13. Benign anorectal abscess and fistula 205 FIGURE 13-16. Advancement flap anorectal. A fistula in ano–transsphincteric. B Enlargement of the outer opening and curettage of granulation tissue. Mobilization of the component C and closing of the internal opening. The suture strand of D in place covering the internal opening. found that fistulectomy, whether primary or secondary, has been associated with a clinically significant disturbance of anal function.

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