The primary cleavage of a fistula in the context of Abszessentlastung is only useful in cases where

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The treatment of the abscess and the Fistelleidens is rule by way of an operative, and depending virkon on the stage of disease manifestation and a more or less urgent surgical virkon indication is given. The abscess must be exposed immediately after diagnosis to prevent the spread of infection with a subsequently even septic virkon disease. Antibiotic therapy is often initiated outpatient is strictly rejected, as it ultimately transported the disease. It is expensive, virkon counterproductive and unnecessary. An emergency relief through regular function and economical incision can facilitate the time to onset of definitive surgical therapy. But it does not replace an adequate, ie sufficiently wide surgical opening. The skin over the abscess must be generous "capped off".
The primary cleavage of a fistula in the context of Abszessentlastung is only useful in cases where you can perform virkon a secure fistula proof without probing with sharp instruments and with an inner Fistelostium not exceed the Dentatalinie.
The course of a fistula is most easily be determined virkon by intraoperative Farbstoffinstillation with methylene blue solution and subsequent probing. The intraoperative probing of the fistula requires sensitive virkon care to avoid a false path of the probe. Button probes are tapered probes, such as the channel probe preferable previously used. The crucial problem in the Fisteltherapie seems the exact knowledge of the anatomy and the subtle and delicate surgical technique to be that avoids the probe a "via falsa".
In the definitive surgical treatment of fistulas different methods compete. They mainly to name three: the fistulotomy (Fistelspaltung) the Fistelexzision possibly with plastic virkon closure of the inner thread Fistelostiums the temporary drainage.
The fistulotomy is considered the standard method. Here is the Fisteldoch together with the subcutaneous tissue and skin is cut with a knife, the fistula virkon is "split". The result instead of the tubular passage of the fistula with a wide open wound ditch. In addition to the severance of the Fisteldaches the wound edges are then removed far. If this flattening of the edges is not made, caused by premature closure of the wound edges Fistelrezidive. It is important to curettage of Fistelbodens to remove all flammable material Proktodealdrüse.
The Fistelexzision with simultaneous closure of the inner plastic Fistelostiums represents an additional, common surgical method. It is and atypical fistulas high gear sphinkterdurchbohrendem reserved. Here is to be avoided with subsequent fecal incontinence by the plastid rule closure of the inner Fistelostiums with simultaneous excision of the extra- and transsphinktärischen portion of the fistula cutting through a larger muscle portion. With regard to the rate of recurrence, the latter method virkon is certainly inferior to the former. The best results shows the fistulotomy, which therefore has to be considered as the general procedure. Special Fistelformen as the rectovaginal or anovaginalen, the technique of plastic flap operation is reserved. In the latter forms may be useful under certain circumstances the additional investment a protective colostomy to guarantee the safety of the plastic closure.
The temporary thread drainage of a fistula also has great clinical significance. She has a completely different principle than the earlier approach often experienced the "filament treatment of fistula after Hippocrates". While doing a slow cut through virkon the muscle virkon was sought that "as the wire the ice block" should cut through the muscle without kontinenzschwächende scar in the drainage thread a loop is loosely inserted into the fistula. This thread acts as a wick and is able to drain the fistula so that as the healing of Abszesswunde not renewed secretion jams. In this way, local inflammation may stabilize and the further course to wait until the final Fistelspaltung alone. The left in the fistula