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藏毛窦疾病的外科治疗

[Surgical treatment of pilonidal disease].

作者信息

Rushfeldt Christian, Søreide Kjetil

机构信息

Avdeling for gastroenterologisk kirurgi, Universitetssykehuset Nord-Norge, 9038 Tromsø, Norway.

出版信息

Tidsskr Nor Laegeforen. 2010 May 6;130(9):936-9. doi: 10.4045/tidsskr.09.0345.

Abstract

BACKGROUND

Pilonidal disease is relatively common and is most often seen in young men. It presents either as acute abscesses or as chronic secretion of pus from inflamed sinus tracts in the gluteal region. Many different methods are used for surgical treatment and recurrences are common. We present an update for surgical treatment of pilonidal disease.

MATERIAL AND METHODS

The article is based on literature identified through a non-systematic search in PubMed and the authors' clinical experience.

RESULTS

An acute abscess has to be drained before curative surgery can be considered. Definitive surgery should be planned for continuous, recurrent or secreting pilonidal disease. A recent meta-analysis indicates that removal of an asymmetric skin flap and primary closure of the wound by mobilising skin from the opposite side (Bascom cleft-lift procedure) is associated with fewest recurrences, shortest time to healing and fewest infections.

INTERPRETATION

The Bascom procedure should be the preferred surgical treatment for patients with pilonidal disease in a chronic phase.

摘要

背景

藏毛窦疾病相对常见,多见于年轻男性。其表现为急性脓肿或臀区发炎窦道的慢性脓液分泌。手术治疗方法多样,复发很常见。我们提供藏毛窦疾病手术治疗的最新情况。

材料与方法

本文基于通过在PubMed上非系统检索以及作者临床经验所确定的文献。

结果

在考虑根治性手术之前,必须先引流急性脓肿。对于持续性、复发性或有分泌物的藏毛窦疾病,应规划确定性手术。最近的一项荟萃分析表明,切除不对称皮瓣并通过从对侧游离皮肤对伤口进行一期缝合(巴斯科姆裂层提升术)复发最少、愈合时间最短且感染最少。

解读

对于处于慢性期的藏毛窦疾病患者,巴斯科姆手术应是首选的手术治疗方法。

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