Duxbury M S, Blake S M, Dashfield A, Lambert A W
Surgical Directorate, Derriford Hospital, Plymouth, UK.
Ann R Coll Surg Engl. 2003 Nov;85(6):405-7. doi: 10.1308/003588403322520799.
Pilonidal disease is a common debilitating condition. This prospective randomised study compared excision of pilonidal disease with a scalpel or diathermy with respect to operation time, postoperative pain, functional recovery and wound healing.
Patients undergoing surgery for pilonidal disease were randomised to excision by scalpel (group 1) or diathermy (group 2). Patients received regular peri-operative oral analgesia and a standardised general anaesthetic technique. Duration of operation was recorded. Following surgery, pain, analgesic requirements, sedation, nausea and vomiting scores and time to mobilise and time to complete healing were compared.
Statistical significance between groups was obtained for five outcomes after 32 patients had been recruited; of these, 81% were admitted as emergencies with an abscess. The duration of surgery in group 2 was significantly less, postoperative pain scores and morphine requirements were lower and mobility was regained sooner.
We advocate the use of diathermy needle rather than scalpel blade when undertaking excision of pilonidal disease in both acute and chronic patients.
藏毛窦疾病是一种常见的使人衰弱的病症。这项前瞻性随机研究比较了使用手术刀或电刀切除藏毛窦疾病在手术时间、术后疼痛、功能恢复和伤口愈合方面的差异。
接受藏毛窦疾病手术的患者被随机分为两组，一组用手术刀切除（第1组），另一组用电刀切除（第2组）。患者接受常规围手术期口服镇痛和标准化全身麻醉技术。记录手术时间。术后比较疼痛、镇痛需求、镇静、恶心和呕吐评分以及活动时间和完全愈合时间。
招募32例患者后，两组在五个结果方面具有统计学意义；其中，81%的患者因脓肿作为急诊入院。第2组的手术时间明显更短，术后疼痛评分和吗啡需求量更低，且恢复活动更快。
我们提倡在对急性和慢性患者进行藏毛窦疾病切除时使用电刀针而非手术刀刀片。
