Perianal Fistula Clinical Trial
Official title:
Pilot Study of SuperSeton Placement in Patients With Perianal Fistulas
Rationale: Perianal fistulas are a common incapacitating problem. Many patients are treated
by seton drainage to prevent recurrent abscess formation. Nowadays, vessel loops or sutures
are used for drainage. The knot of these seton drains can cause complaints of pain or
tenderness if it presses against the external opening of the fistula or even slides in to the
fistula tract. Medishield B.V. designed a knotless seton drain, the SuperSeton. This could
decrease the pain complaints caused by the knot.
Objective: The aim of this study is to determine the feasibility of SuperSeton placement in
patients with perianal fistulas.
Study design: The design of the study is a feasibility study.
Study population: Patients (≥ 18 years) with perianal fistulas (ever) treated with a knotted
seton are eligible.
Intervention: The SuperSeton will be placed at the outpatient clinic in patients that already
have a seton in situ. This seton will then be exchanged by the SuperSeton. In case patients
do not have a seton in situ, the SuperSeton can be placed at the operating theatre in day
care setting instead of a regular seton.
Main study parameters/endpoints: The primary outcome is seton failure (loosening of the
seton). Secondary outcomes are time of procedure, complications and quality of life measured
by the PDAI ('Perianal Disease Activity Index').
Nature and extent of the burden and risks associated with participation: The SuperSeton will
be placed in patients with perianal fistulas (ever) treated with a conventional knotted
seton. There are no additional risks involved. The seton will be placed at the outpatient
clinic in patients with a seton in situ, or at the operating theatre in day care setting in
patients with a perianal abscess without a seton. The material that is used for the Setons is
of medical grade polyurethane, this is the same material of catheters that are already used
in clinical practice (instech BTPU 027). The Setons including the insert (BTPU) are supplied
sterile (Synergy Health). Sample size calculation: A group of 60 patients will be included to
determine feasibility of the SuperSeton. The proposed treatment protocol is considered
feasible if at least 70% of the SuperSetons stay in place.
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