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A combination therapy protocol investigated by Sheba Medical Center for the treatment of perianal Crohn's disease. The treatment involves the induction of local healing conditions using the monoclonal antibody infliximab, followed by the surgical instillation of fibrin glue into perianal fistulae. Infliximab acts as a TNF-alpha inhibitor to reduce systemic and local inflammation, while the fibrin glue (a biologic sealant composed of fibrinogen and thrombin) provides a mechanical plug and a biological scaffold to facilitate the closure and healing of the fistula tracts. This sequential approach aims to optimize the environment for fistula closure by combining anti-inflammatory biological therapy with mechanical and biological sealing.
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