Tocchi Adriano, Mazzoni Gianluca, Bononi Marco, Fornasari Vittorio, Miccini Michelangelo, Drumo Andrea, Colace Lidia
1st Department of Surgery, La Sapienza University, School of Medicine, Umberto I Hospital, Viale del Policlinico 155, 00161 Rome, Italy.
Am J Surg. 2008 Jul;196(1):28-33. doi: 10.1016/j.amjsurg.2007.05.051.
Pilonidal sinus (PS) is a common chronic disorder of the sacrococcygeal region. The optimal treatment for PS remains controversial, and recent reports have advocated different surgical approaches.
A prospective study was performed on 103 patients with nonrecurrent quiescent chronic discharging sinus. Excision with primary closure was performed on all patients. Patients were subdivided randomly into 2 groups. In group A, the excision was associated with drainage of the wound; in group B, the wound was not drained.
Excision with primary closure and drainage was performed in 53 patients (group A). Drainage was omitted in 50 patients (group B). Minor wound complications occurred in 3 patients in group A and in 36 patients in group B. No complete dehiscence of the wound was observed in patients in group A and in 8 patients in group B. Complete healing was fastest in patients in group A. Sinus recurrence occurred in 1 patient in group A and in 2 patients in group B.
Short- and long-term results suggest that limited midline excision with primary closure and wound drainage is a simple and effective procedure in the surgical treatment of uncomplicated PS. More demanding flap techniques and plasties should be reserved for complicated PS, which requires a wider excision.
藏毛窦（PS）是骶尾部常见的慢性疾病。PS的最佳治疗方法仍存在争议，近期报告提倡采用不同的手术方法。
对103例非复发性静止性慢性流脓性窦道患者进行前瞻性研究。所有患者均行一期缝合切除。患者被随机分为2组。A组切除同时进行伤口引流；B组伤口不引流。
53例患者（A组）行一期缝合切除并引流。50例患者（B组）未进行引流。A组3例患者和B组36例患者出现轻微伤口并发症。A组患者及B组8例患者未观察到伤口完全裂开。A组患者愈合最快。A组1例患者和B组2例患者出现窦道复发。
短期和长期结果表明，对于单纯性PS的手术治疗，有限的中线切除并一期缝合及伤口引流是一种简单有效的方法。更复杂的皮瓣技术和整形手术应保留用于需要更广泛切除的复杂性PS。
