What is a fistula? · Local ozone application · Human data · Surgical approach · Ozonated oil and wound support · Abscess and Crohn’s
What is a fistula?
Underlying an abnormal tract developing between the anal canal and the perianal skin, there may be an abscess, chronic infection, Crohn’s disease, or a history of surgery. Fistula anatomy and sphincter relationship form the cornerstone of the treatment plan.
Local ozone application
The Madrid Declaration addresses controlled ozone insufflation into the fistula tract as one of the defined routes of administration. In the clinical approach, the goal is not to ignore fistula anatomy; it is to evaluate supportive targets such as the local tissue environment, microbial load, and wound healing in selected cases.
How should human data be interpreted?
In a small prospective study of 12 patients with chronic anal fistula, the permanent closure rate with ozone insufflation alone was found to be low. This result suggests that rather than using ozone alone for fistula closure, investigating its local supportive role accompanying surgery or wound care may be more rational.
Surgical approach
Colorectal surgical methods are the primary approach based on fistula anatomy, sphincter relationship, and symptoms. Simple and complex fistulas are managed differently. If ozone application is considered, it is planned in accordance with the surgical evaluation and drainage requirements.
Ozonated oil and wound support
In a 2024 pediatric series, favorable wound healing was reported with ozonated oil dressing after VAAFT. Although an uncontrolled study, this result provides a positive clinical signal supporting the evaluation of the role of ozonated products in post-procedure local wound support through larger studies.
Considerations in abscess and Crohn’s disease
If an active abscess is present, drainage must be performed in a timely manner. In Crohn’s-related fistulas, gastroenterology and colorectal surgery approaches are conducted jointly. Local ozone is evaluated only through supportive goals aligned with this primary plan.
Our Approach at Our Bodrum Clinic
In fistula evaluation, tract anatomy, active infection or abscess, Crohn’s disease, and surgical requirements are determined first. If ozone is considered, we define its objective as local tissue support, wound healing, and complementary care in selected patients, rather than closing the fistula on its own.
Related ozone applications
References
- Ozturk E, et al. Prospective study of ozone insufflation in chronic anal fistula. Review the source
- ASCRS Clinical Practice Guidelines for anorectal abscess/fistula. 2022. Review the source
- VAAFT combined with ozonide oil dressing in pediatric patients. Surg Endosc. 2024. Review the source
- Madrid Declaration on Ozone Therapy.
