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Comparison of hydrogen peroxide instillation with Goodsall’s fule for fistula-in-ano by P. A. H. A. Gunawardhana; K. I. Deen is a Medicine article available to read on EtoBox.

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**Background**: Identification of the internal opening is an essential step in the management of fistula‐in‐ano. The predictive accuracy of Goodsall’s rule is compared with instillation of hydrogen peroxide for fistulas‐in‐ano. **Methods**: Thirty‐five patients (32 male, three female; median age 42 years; range: 6 months–70 years) were studied. Hydrogen peroxide solution was injected into the external opening of the fistula track and effervescence was observed at the internal opening within the anal canal. A fistula track was either excised or incised. Setons were placed within high fistulas. **Results**: There were 24 simple fistulas, compared to 11 complex fistulas (horseshoe, __n__ = 4; abscess, __n__ = 4). Eighteen external openings were anterior and 17 were posterior. Thirty‐four of 35 (97%) internal openings were identified. Only 20 internal openings were in accordance with Goodsall’s rule (positive predictive value: 59%). Predictive accuracy was greater for anterior external openings (13 of 18 (72%)) versus posterior external openings (six of 17 (41%); __P__ = 0.016). For recurrent fistulas, seven of 17 fistula tracks had an internal opening in accordance with Goodsall’s rul

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Author

P. A. H. A. Gunawardhana; K. I. Deen

Publisher

John Wiley and Sons; Blackwell Publishing; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 1445-1433)

Published

2001

Language

EN

Field

Medicine (Health Sciences)