Conditions/Anal Fistula/Chapter
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.
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
- Aftercare that protects the flapTap for details · key note inside
Avoid straining and keep stools soft in the early weeks. Flap tension or infection raises recurrence risk. Keep follow-up appointments.
- Flap versus LIFTTap for details
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?Tap for details
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?Tap for details
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
Anal Fistula Symptoms
Discharge, recurrent abscess, and urgent warning signs
Anal Fistula Diagnosis
Exam, MRI mapping, and Parks classification
Anal Fistula Treatment Options
Fistulotomy, seton, LIFT, flap, and other options
Anal Fistula Classification
Classification — explained for shared decision-making
Fistulotomy
Lay-open for selected low, simple tracks
Seton for Anal Fistula
Seton: what the procedure aims to do and who it fits
Living with a Seton
Hygiene, activity, and warning signs while draining
LIFT Procedure for Anal Fistula
LIFT: what the procedure aims to do and who it fits
Crohn’s and Anal Fistula
Medical therapy plus drainage/seton — shared plan
Anal Fistula Technique Comparison
Comparison — explained for shared decision-making
After Fistula Surgery
Wound care, soft stools, and return to activity
Fistula Recurrence
Why tracks return and how the next plan is built
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.