{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:53:23Z","timestamp":1783040003097,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,6,8]],"date-time":"2016-06-08T00:00:00Z","timestamp":1465344000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The use of a loose seton for complex anal fistulae can cause perianal discomfort and reduced quality of life. The aim of this study was to assess the impact of the novel knot\u2010free Comfort Drain on quality of life, perianal comfort and faecal continence compared to conventional loose setons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Forty\u2010four patients treated for complex anal fistula at a single institution between July 2013 and September 2014 were included in the study. A matched\u2010pair analysis was performed to compare patients with a knot\u2010free Comfort Drain and controls who were managed by conventional knotted setons. The 12\u2010item Short Form survey (<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201012) questionnaire was used to assess quality of life. Additionally, patients reported perianal comfort and faecal incontinence using a Visual Analog Scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) and the St Mark's Incontinence Score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Comfort Drain was associated with improved quality of life with significant higher median physical (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001) and mental (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04) health scores compared with a conventional loose seton. According to the <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>, patients with a Comfort Drain <jats:italic>in\u00a0situ<\/jats:italic> reported greater perianal comfort with significantly less burning sensation (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and pruritus (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001). Faecal continence was similar in each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Comfort Drain offers improved perianal comfort and better quality of life compared with a conventional loose seton and therefore facilitates long\u2010term therapy in patients with complex fistula\u2010in\u2010ano.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13335","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T02:47:21Z","timestamp":1458614841000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life"],"prefix":"10.1111","volume":"18","author":[{"given":"I.","family":"Kristo","sequence":"first","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Stift","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Staud","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kainz","sequence":"additional","affiliation":[{"name":"Department of Nephrology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bachleitner\u2010Hofmann","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chitsabesan","sequence":"additional","affiliation":[{"name":"York Teaching Hospital NHS Foundation Trust York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Riss","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,8]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"219","article-title":"Fistula\u2010in\u2010ano in a defined population. 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