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Pilonidal sinus – diagnosis at the intersection of general and plastic surgery


Authors: F. Pazdírek 1;  M. Kouda 1;  Z. Jech 1;  L. Frajer 2;  J. Hoch J 1
Authors place of work: Chirurgická klinika 2. LF UK a FN Motol, přednosta: prof. MUDr. J. Hoch, CSc. 1;  Oddělení plastické chirurgie, Chirurgická klinika 2. LF UK a FN Motol, vedoucí lékař: MUDr. R. Kufa 2
Published in the journal: Rozhl. Chir., 2014, roč. 93, č. 11, s. 545-548.
Category: Původní práce

Summary

Introduction:
Pilonidal sinus predominantly affects young patients. Improper treatment results in long-term restrictions in everyday life and incapacity for work. The aim of the study was to find out what the results and current treatment options of pilonidal sinus are. Material and methods: This is a retrospective analysis of 67 patients treated at the Department of Surgery of the Second Medical Faculty of Charles University and Motol Hospital in the period 2010−2013. We evaluated the type of surgery and infectious complications in the wound, as well as age, sex, BMI, smoking, employment of the patients, duration of wound drainage, length of hospital stay, time required to complete healing of the surgical wound, the surgeon’s erudition and disease recurrence. Results: 50 (75%) patients underwent primary closure in the midline, Limberg flap was used in 15 (22%) patients. In 2 (3%) patients, the wound was left without suture. In the group of patients who had not undergone flap reconstruction, secondary wound healing occurred in 20 (40%) patients. In the group of patients where flap reconstruction was used, secondary healing occurred in 3 patients (20%). Relapse of the disease within one year occurred in the group of patients with primary suture in the midline in 4 (8%) patients; other patients had no recurrence. Conclusion: According to our experience as well as literary data, the treatment of choice is the extirpation of the sinus with primary suture beyond the midline using a flap reconstruction technique. Key words: pilonidal sinus − flap reconstruction − complication


Zdroje

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3. Al-Khamis A, et al. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev 2010;1:CD006213.

4. Horwood J, et al. Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trials. Colorectal Dis 2012;14:143−151.

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10. Can M, et al. Multicenter prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease. Am J Surg 2010;200:318−327.

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12. Milone, et al . The role of drainage after excision and primary closure of pilonidal sinus: a meta-analysis, Tech Coloproctol 2013;17:625−630.

13. Sievert H, et al.The influence of lifestyle (smoking and body mass index) on wound healing and long-term recurrence rate in 534 primary pilonidal sinus patients, Int J Colorectal D 2013;28:1555−1562.

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Štítky
Chirurgie všeobecná Ortopedie Urgentní medicína

Článek vyšel v časopise

Rozhledy v chirurgii

Číslo 11

2014 Číslo 11
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