Application of biomaterials for complex anal fistulae

Complex anal fistulae remain a challenge for the medical sector as conventional treatments put patients at risk of incontinence. Clinicians and researchers have become interested in the application of bioresorbable materials, as a means of avoiding invasive procedures and/or secondary procedures. Advances in polymer chemistry and processing techniques, the range of biomaterial medical devices has expanded since first implemented in the early 1990s. Devices were initially modeled off the collagen Surgisis^® anal fistula plug and biologic sealants, primarily as tissue scaffolds. Clinical evaluation of these biomaterial medical devices initially generated great enthusiasm, however; subsequent studies observed low—moderate success rates. The next generation of biomaterial devices focus on novel device design and the incorporation of bioactives and biologics for the amelioration of disease persistent factors. This review focuses on the biomaterials utilized, the form of medical device developed and the recent inclusion of dual-purpose scaffolds for complex anal fistulae treatments.