Treatment of anovaginal fistulas with an anocutaneous flap in patients with Crohn's disease.

We report on a new and simple operative technique for closure of anovaginal fistulas with an anocutaneous flap in patients with Crohn's disease. From January 1989 till December 1990 this operation was performed in 10 women with Crohn's disease. Seven of the ten patients suffered from Crohn's proctitis. In these patients a protective enterostomy was applied before the operative closure of the fistula. All fistulas healed primarily. Within a median follow up of 18 months (7-24 months) a relapse occurred in 3 patients; two of these were treated successfully with fibrin injection in one case and a further operative closure of the fistula using the same procedure in the second case. In the third patient a seton was placed into the recurrent fistula track, which is still present after 4 weeks.