Department of General Surgery, Brookdale University Hospital and Medical Center, Brooklyn, NY 11212, USA.
J Pediatr Surg. 2011 Jun;46(6):1256-9. doi: 10.1016/j.jpedsurg.2011.03.062.
BACKGROUND/PURPOSE: The cleft lift for pilonidal disease is a flap procedure designed to counteract suspected causes of closed-technique failure. This study compares cleft lift with wide excision and packing in adolescents with respect to complications, healing, and recurrence.
Charts of all patients surgically treated for pilonidal disease at our institution from August 2000 to August 2009 were reviewed retrospectively. Wide excision was routinely performed until May 2007 when the cleft lift as described by Bascom was instituted here. Factors examined were postoperative complications, wound healing, and disease recurrence.
Seventy patients (49 males, 21 females; mean age, 16 years; mean weight, 170.5 lb) with pilonidal disease underwent a total of 39 cleft lift procedures and 34 wide excision procedures. All but 1 cleft lift patient (97.4%) healed completely, whereas 25 (73.5%) of 34 patients in the excision group healed (P < .001). The remaining 9 excision patients had chronic wounds, 3 of whom have undergone cleft lift with full healing. One cleft lift patient had recurrent disease (2.5%) compared with 7 (20.6%) of 34 excision patients (P < .02).
The cleft lift procedure is a superior treatment method of pilonidal disease in adolescents, resulting in primary healing, lower likelihood of recurrent disease, and simplified wound care.
背景/目的：藏毛窦切开术是一种皮瓣手术，旨在对抗可能导致闭合技术失败的原因。本研究比较了藏毛窦切开术与广泛切除和填塞在青少年中的并发症、愈合和复发情况。
回顾性分析 2000 年 8 月至 2009 年 8 月我院接受手术治疗的所有藏毛窦病患者的病历。广泛切除术一直常规进行，直到 2007 年 5 月，我们开始采用 Bascom 描述的藏毛窦切开术。检查的因素包括术后并发症、伤口愈合和疾病复发。
70 例（49 例男性，21 例女性；平均年龄 16 岁；平均体重 170.5 磅）患有藏毛窦病，共行 39 例藏毛窦切开术和 34 例广泛切除术。除 1 例藏毛窦切开术患者（97.4%）完全愈合外，切除组 34 例患者中有 25 例（73.5%）愈合（P <.001）。其余 9 例切除患者有慢性伤口，其中 3 例接受藏毛窦切开术完全愈合。1 例藏毛窦切开术患者（2.5%）出现疾病复发，而 34 例切除患者中有 7 例（20.6%）（P <.02）。
藏毛窦切开术是青少年藏毛窦病的一种较好的治疗方法，可实现一期愈合、降低疾病复发的可能性，并简化伤口护理。
