Fistulotomy

FISTULOTOMY

Goodsall's  rule Fig. 19.8 is often helpful in decending for  the

direction of the tract.

In  fistulas anterior to an imaginary transverse  line  bisecting

the  anus, usually the tract proceeds from opening in a  straight

line to the primary opening in anal canal.

In fistulas posterior to the line usually arise from an  internal

opeing in the posterior midline.

Treatment  is  surgical and consists of unroofing  all  fistulas,

destroying the primary opening and establishing adequate drainage

as in anal fissures.

POST-OPERATIVE MANAGEMENT

Wound  should be kept open post-operatively to  promote  drainage

and allow healing from the depth of the incision.

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