How to Insert a Draining Seton Correctly

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Abstract

INTRODUCTION:

Misconceptions exist about the proper way to use draining setons in the management of anal fistulas. This technical note lays out the principles for their use.

TECHNIQUE:

Insertion of draining setons is a prerequisite to successful management of anal fistulas. The correct technique involves identification of the correct track and internal opening and drainage of the track with a silastic seton. This sets the stage for definitive repair after the inflammation subsides.

RESULTS:

Three cases are presented to illustrate common errors made during the insertion of draining setons.

CONCLUSIONS:

Appropriate seton drainage of an anorectal fistula is an important part of the ultimate repair. Correct use of setons minimizes symptoms from the seton itself and optimizes its effectiveness.

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