Written and medically reviewed by: Assoc. Prof. Cengiz Dibekoğlu, MD, General SurgeryLast updated:
Advancement Flap for Anal Fistula
Closing the internal opening with healthy tissue — sphincter-sparing for selected high tracks
An advancement flap uses healthy rectal or anal mucosa to cover the internal opening and shut off the tunnel’s source. It is a common sphincter-sparing option for higher fistulas. Success varies by series; recurrence leads to a revised plan.
Educational schematic. Some structures may be simplified or emphasized for clarity; not an exact anatomical depiction.
© Cengiz Dibekoğlu — illustrative; not for unauthorized use
Figure summary
This educational figure shows: Advancement flap.
Who may be a candidate?
- High or complex fistulas
- Patients for whom sphincter preservation is critical
- Tracks calmed after a drainage seton
Step-by-step overview
- 1
Internal opening
The internal opening is identified; infected tissue is cleaned.
- 2
Flap preparation
Healthy tissue is advanced and sutured over the internal opening.
- 3
External pathway
The external opening may be left for drainage or otherwise managed.
Key points
- Key note inside
Aftercare that protects the flap
Avoid straining and keep stools soft in the early weeks. Flap tension or infection raises recurrence risk. Keep follow-up appointments.
Flap versus LIFT
Anatomy and prior operations decide. Both are sphincter-sparing; one is often chosen after a seton period.
Frequently asked questions
Is some discharge normal after a flap?
If the external tract is left open for drainage, light discharge can persist briefly. Rising discharge, foul smell, fever, or new swelling needs review.
If the flap fails, can surgery be repeated?
Yes. Infection is controlled first and anatomy reassessed; then seton, LIFT, repeat flap, or another suitable method may be chosen.
More chapters in this hub
Diagnosis & anatomy
Anal Fistula Symptoms
Discharge, recurrent abscess, and urgent warning signs
What Causes an Anal Fistula?
Abscess, Crohn’s, and other triggers
Abscess and Fistula Link
Infection first, tunnel second
Anal Fistula Classification
Simple versus complex — explained for shared decisions
Anal Fistula Diagnosis
Exam, MRI mapping, and Parks classification
Simple fistula
Complex fistula
Seton
LIFT / flap
Crohn
Newer sphincter-preserving techniques
Recovery / recurrence / continence
Appointment / info
This page is for education. It is not medical advice and does not replace a visit with your physician.
Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.