Development of a Novel Anal-Fistula Plug Scaffold from Porcine Acellular Dermal Matrix/Hyaluronic Acid and Autologous Concentrated Growth Factor for Accelerating Fistula Healing

In this study, a novel fistula plug stent (ACGF@G-PADM/HA) was designed to accelerate fistula healing. The scaffold uses a composite matrix of porcine acellular matrix and hyaluronic acid (PADM/HA) as a three-dimensional porous collagen framework, which functions as the "structural support", and autologous concentrated growth factor (ACGF) is a highly concentrated bioactive agent extracted from the patient's own blood, rich in a variety of growth factors, acting as "functional agents". The as-developed ACGF@G-PADM/HA plug scaffold showed excellent mechanical strength, overcoming defects such as the fast gelation of fibrin glue and the fixed shape of the anal plug, which allowed it to conform to the irregular and complicated structures of the fistula. Simultaneously, the ACGF was employed to induce angiogenesis (neovascularization) and fibroblast proliferation, thereby attaining a synergistic effect in promoting fistula healing. The novel filling material was capable of effectively preventing bacterial contamination, promoting the proliferation of granulation tissue, and accelerating wound healing. This facilitated tissue remodeling and ensured the integration of the fistula plug with the host tissue prior to its expulsion. The study anticipates that this new filling material can be utilized as a potential fistula plug scaffold for fistula treatment.