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This study aimed to assess the results of anocutaneous advancement flap in a consecutive cohort of patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a retrospective, observational study. From 2000 to 2011, 481 patients had been operated for a single chronic anal fissure at the Maingau Clinic of the German Red Cross in Frankfurt am Main. The intention was to excise the fissure by fissurectomy (FIS) and then to cover the wound primarily with an anocutaneous advancement flap (AAF). The primary outcomes were resolution of symptoms and healing rates 1\u00a0month postoperatively. Secondary outcomes included incidences of early and late complications, postoperative incontinence, and recurrent fissure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Anocutaneous advancement flap was performed in 455 (94.6%). In 26 (5.4%) patients, AAF failed due to lacking skin and the wound left open after FIS. One month postoperatively, half of the patients with AAF were free of symptoms (53.2%) with complete wound healing (47.9%). The incidence of early complications within 1\u00a0month postoperatively was 0.9% after AAF. From 1\u00a0month to 5\u00a0years after operation anal abscesses and fistula occurred in 2.9%. Mild symptoms of anal incontinence were recorded in 0.2% and recurrent chronic anal fissure in 3.3% of patients. Subgroup analysis revealed improved wound healing 1\u00a0month postoperatively in patients with AAF compared to FIS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Anocutaneous advancement flap is a very safe sphincter-sparing surgical option for CAF, provides a quicker cure than fissurectomy, and may be considered a good first-line surgical treatment option for chronic anal fissures if medical treatment failed.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-021-02227-4","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T19:02:27Z","timestamp":1624388547000},"page":"2861-2867","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Anocutaneous advancement flap provides a quicker cure than fissurectomy in surgical treatment for chronic anal fissure\u2014a retrospective, observational study"],"prefix":"10.1007","volume":"406","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-5612","authenticated-orcid":false,"given":"Edgar","family":"Hancke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Suchan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Voelke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"issue":"2","key":"2227_CR1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s10151-011-0683-7","volume":"15","author":"DF Altomare","year":"2011","unstructured":"Altomare DF, Binda GA, Canuti S et al (2011) The management of patients with primary chronic anal fissure: a position paper. 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