Washer Joshua D, Smith Dane E, Carman Mary E, Blackhurst Dawn W
Academic Department of Surgery, Greenville Hospital System, University Medical Center, 701 Grove Road, Greenville, SC 29605, USA.
Am Surg. 2010 Feb;76(2):154-6.
The ideal elective surgical procedure for pilonidal disease is debated. Simple excision and closure is commonly performed but is associated with a high incidence of wound complications and recurrence. We developed a simple modification of primary closure, which involves the elevation, mobilization, and closure of the gluteal fascia. The purpose of this study is to compare outcomes of this gluteal fascial advancement technique with standard primary closure for the treatment of pilonidal disease. We retrospectively reviewed our surgical database to include all patients who underwent surgery for pilonidal disease from 2004 to 2007. Patients who underwent primary closure (n = 66) were compared with patients who underwent gluteal fascial advancement (n = 17). Demographic data as well as recurrence and the incidence of wound complications were examined. There was a significant difference in incidence of wound breakdown (0 vs 21%), recurrence (0 vs 20%), and early wound drainage (6 vs 32%). Overall there was an 80 per cent reduction in wound complications after gluteal fascial advancement compared with primary closure. Gluteal fascial advancement is a simple modification of standard primary closure and is associated with fewer wound complications and recurrences.
藏毛疾病理想的择期手术方式存在争议。单纯切除缝合是常用的术式，但伤口并发症和复发的发生率较高。我们对一期缝合进行了一项简单改良，包括臀筋膜的游离、上移和缝合。本研究旨在比较这种臀筋膜推进技术与标准一期缝合治疗藏毛疾病的疗效。我们回顾性分析了手术数据库，纳入2004年至2007年间所有因藏毛疾病接受手术的患者。将接受一期缝合的患者（n = 66）与接受臀筋膜推进术的患者（n = 17）进行比较。分析了人口统计学数据以及复发情况和伤口并发症的发生率。伤口裂开发生率（0% 对21%）、复发率（0% 对20%）和早期伤口引流情况（6% 对32%）存在显著差异。总体而言，与一期缝合相比，臀筋膜推进术后伤口并发症减少了80%。臀筋膜推进术是对标准一期缝合的简单改良，可减少伤口并发症和复发。
