Fazeli Mohammad Sadegh, Adel Maryam Ghavami, Lebaschi Amir H
Department of Surgery, Imam Medical Complex, Tehran University of Medical Sciences, Tehran, Iran.
Dis Colon Rectum. 2006 Dec;49(12):1831-6. doi: 10.1007/s10350-006-0726-8.
Pilonidal sinus is a common disease, mostly among young males. Although the conventional surgery, secondary repair of the wound after wide excision with or without curettage, is not technically difficult, it takes a long time, weeks or months, for a wound to heal. In this study, we compared outcomes and complications of Z-plasty repair with outcomes and complications of delayed healing by secondary intention (conventional surgery).
In a randomized, clinical trial, we recruited 72 patients in each arm. All of the patients were operated on by a general surgeon and were followed up for variable periods. Patients in the Z-plasty arm were followed for a mean period of 22.01 months. Patients conventional surgery arm were followed for a mean period of 22.23 months. The main studied outcomes were healing of the wound and disease recurrence during the follow-up period. The main complications that were taken into account were bleeding, hematoma, infection, and recurrence.
The two arms were comparable in the age and gender distributions, duration of disease, and history of any types of operations. The duration of hospitalization after the operation was shorter in the conventional surgery group (1.76+/-0.75 days vs. 2.86+/-0.73 days, P<0.001). However, wounds healed much faster in the Z-plasty group (15.4 vs. 41 days, P<0.001). Moreover, it took longer for patients in the conventional surgery group to return to normal activity (17.5 vs. 11.9 days, P<0.001). There was no difference in postoperative complications regarding bleeding, hematoma, infection, or recurrence during the follow-up period in two arms.
Healing was considerably faster in patients who were treated with Z-plasty technique of wound closure. This procedure can be used as a desirable treatment for pilonidal sinus, which is a noncomplex method without increased rate of complications. Nonetheless, it might slightly increase the duration of hospitalization.
藏毛窦是一种常见疾病，多见于年轻男性。尽管传统手术，即广泛切除后行伤口二期修复（有无刮除）技术上并不困难，但伤口愈合需要很长时间，数周或数月。在本研究中，我们比较了Z成形术修复与二期愈合（传统手术）的结果及并发症。
在一项随机临床试验中，每组招募72例患者。所有患者均由普通外科医生进行手术，并进行了不同时间段的随访。Z成形术组患者的平均随访时间为22.01个月。传统手术组患者的平均随访时间为22.23个月。主要研究结果是随访期间伤口愈合情况和疾病复发情况。考虑的主要并发症包括出血、血肿、感染和复发。
两组在年龄、性别分布、病程和任何类型手术史方面具有可比性。传统手术组术后住院时间较短（1.76±0.75天对2.86±0.73天，P<0.001）。然而，Z成形术组伤口愈合快得多（15.4天对41天，P<0.001）。此外，传统手术组患者恢复正常活动所需时间更长（17.5天对11.9天，P<0.001）。两组随访期间术后出血、血肿、感染或复发等并发症无差异。
采用Z成形术伤口闭合技术治疗的患者愈合速度明显更快。该手术可作为藏毛窦的理想治疗方法，这是一种不复杂的方法，且并发症发生率没有增加。尽管如此，它可能会稍微延长住院时间。
