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Analysis of mechanical response of fistula plug for structure optimization

Theoretical & Applied Mechanics Letters 2012年第1期2卷 36-39页

作者： Shunli Yang Bin Jiang Feng Xu Min Lin Guiping Zhao Tianjian Lu Biomedical Engineering and Biomechanics Center Xi'an Jiaotong UniversityXi'an 710049China NanJing Hospital of T.C.M Nanjing 210001China The Key Laboratory of Biomedical Information Engineering of Ministry of Education School of Life Science and TechnologyXi'an Jiaotong UniversityXi'an 710049China

Anal fistula is one of the three greatest anorectal diseases with a high prevalence. The traditional treatments（e.g., surgery） for fistula have limitations due to damage to the internal anal sphincter of patients. With recent advances in biomaterials, treatments based on biomaterial filling （e.g., scleraprotein injection, fistula plug） have emerged as novel therapies for fistula. The anal fistula plug （e.g., based on small intestinal submucosa （SIS）） has attracted increasing attention because of short term healing rate and biocompatibility. However, challenges remain for this method such as plug falling as observed in clinics. To address this, this paper analyzes the case of SIS falling under physiological condition from mechanical point of view using ANSYS simulation. It then proposes three new geometrical structures for fistula plug and compares their mechanical behavior （e.g., axial stress, reaction of constraint） with that of clinically used structure （cone shape）. Based on the simulation, it optimizes the geometric parameters of fistula plug. The approach developed here can help to improve the design of fistula plug for better clinical treatments.

关键词： anal fistula small intestinal submucosa fistula plug structure optimization numerical simulation

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Idiopathic fistula-in-ano

引用

World Journal of Gastroenterology 2011年第28期17卷 3277-3285页

作者： Sherief Shawki Steven D Wexner Department of Colorectal Surgery Cleveland Clinic Florida Department of Surgery Suez Canal University

fistula-in-ano is the most common form of perineal ***,a fistula includes an internal opening,a track,and an external *** external opening might acutely appear following infection and/or an abscess,or more insiduously in a chronic *** includes control of infection,assessment of the fistulous track in relation to the anal sphincter muscle,and finally,definitive treatment of the *** was the most commonly used mode of management,but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps,fibrin glue,collagen fistula plug,ligation of the intersphincteric fistula track,and stem *** descriptive and comparative studies have evaluated these different techniques with variable *** lack of consistent results,level I evidence,or long-term follow-up,as well as the heterogeneity of fistula pathology has prevented a definitive treatment *** article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano.

关键词： Anal fistula Seton Fistulotomy Advancement flap Fibrin glue fistula plug

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