Al-Khayat Haitham, Al-Khayat Hisham, Sadeq Adnan, Groof Ala, Haider Hani H, Hayati Hussein, Shamsah Abdulla, Zarka Zaki Anas, Al-Hajj Hani, Al-Momen Abdulhameed
Department of Surgery, Saad Specialist Hospital, Al-Khobar, Saudi Arabia.
J Am Coll Surg. 2007 Sep;205(3):439-44. doi: 10.1016/j.jamcollsurg.2007.04.034. Epub 2007 Jun 27.
Pilonidal disease is a common condition among young people. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation. The aim of our study is to report our experience with Karydakis procedure and explore the risk factors associated with infection and poor healing in pilonidal operation.
A 3-year experience of a Joint-Commission International accredited tertiary center in patients with pilonidal sinus operations is reported. We retrospectively reviewed the charts of unselected patients with pilonidal sinus who underwent excision and primary closure on elective basis in terms of wound healing, surgical site infection, and return to work. Variables predictive of surgical site infection and disruption were assessed by multiple logistic analyses.
From January 2004 to December 2006, 94 patients with pilonidal disease underwent excision and primary closure on elective basis. Incidence of surgical site infection was 12.8%. No recurrence was observed after median followup of 6 months, with interquartile range of 4 to 9 months. Smoking (p = 0.027) and obesity (p = 0.047) were independent risk factors for wound infections.
Excision and primary closure is an acceptable modality of treatment in nonobese and nonsmoker patients with pilonidal sinus disease. Infection rate in obese patients and smokers is unacceptably high, and active preoperative weight loss and smoking cessation or simple laid open procedure is recommended in these patients.
藏毛窦疾病在年轻人中较为常见。复杂的藏毛窦手术伤口会导致相当高的发病率，包括慢性骶尾部伤口、工作时间损失和生活方式受限。我们研究的目的是报告我们应用卡里达基斯手术的经验，并探讨藏毛窦手术中与感染及愈合不良相关的危险因素。
报告一家获得国际联合委员会认证的三级中心3年来对藏毛窦患者进行手术的经验。我们回顾性分析了未筛选的择期接受切除及一期缝合的藏毛窦患者的病历，内容包括伤口愈合、手术部位感染及恢复工作情况。通过多因素逻辑分析评估预测手术部位感染及伤口裂开的变量。
2004年1月至2006年12月，94例藏毛窦疾病患者择期接受了切除及一期缝合手术。手术部位感染发生率为12.8%。中位随访6个月（四分位间距为4至9个月），未观察到复发情况。吸烟（p = 0.027）和肥胖（p = 0.047）是伤口感染的独立危险因素。
对于非肥胖且不吸烟的藏毛窦疾病患者，切除及一期缝合是一种可接受的治疗方式。肥胖患者和吸烟者的感染率高得令人无法接受，建议这些患者术前积极减重、戒烟或采用单纯开放手术。
