Eskisehir Military Hospital, Clinic of General Surgery, Eskisehir, Turkey.
Dis Colon Rectum. 2011 Sep;54(9):1155-61. doi: 10.1097/DCR.0b013e318222e334.
Monopolar electrocauterization produces thermal effects on neighboring tissues, causing tissue damage. Recently, tissue sealing-cutting devices, which are easy to use and achieve simultaneous selective sealing and cutting with less production of heat, have been used.
The aim of this study was to investigate the effects of a tissue sealing-cutting device vs monopolar electrocautery on wound healing in the early postoperative period after pilonidal sinus surgery.
This study was a prospective randomized clinical trial.
This study was conducted at Military Hospital, Eskisehir, Turkey.
In total, 128 patients with chronic pilonidal disease were randomly assigned into 2 clinically comparable groups between December 2009 and June 2010.
Pilonidal sinus excision was performed with monopolar electrocautery in the control group (n = 64) and with a tissue sealing-cutting device in the study group (n = 64). Data regarding wound healing, demographic variables, history, physical examination findings, defect dimensions, and scores for a visual analog scale were recorded.
The main outcomes measured were surgical site infection, early wound failure (dehiscence), and unhealed wound rate.
: Wound infection and dehiscence rates were significantly lower (P = .01 and .02), but the duration of surgery was significantly longer (P < .01) in the tissue sealing-cutting group. The unhealed wound rate was 12.5% in the electrocautery group and 4.7% in the tissue sealing-cutting group (P = .01). When the distance from the lowest margin to the anus was 5 cm or less, wound infection and dehiscence rates were lower in the tissue sealing-cutting group (P < .01 and .03).
We could not obtain data regarding the cost-effectiveness of the instruments.
A tissue sealing-cutting device in pilonidal sinus surgery yields better wound healing than monopolar electrocautery.
单极电灼会对邻近组织产生热效应，导致组织损伤。最近，使用了易于操作且能实现选择性同时密封和切割、产生热量较少的组织密封切割装置。
本研究旨在探讨组织密封切割装置与单极电灼在肛瘘手术后早期对伤口愈合的影响。
这是一项前瞻性随机临床试验。
该研究在土耳其埃斯基谢希尔军事医院进行。
2009 年 12 月至 2010 年 6 月期间，共有 128 例慢性肛瘘病患者被随机分为 2 个临床可比组。
对照组（n=64）采用单极电灼进行肛瘘切除，研究组（n=64）采用组织密封切割装置进行。记录伤口愈合、人口统计学变量、病史、体格检查结果、缺损尺寸以及视觉模拟量表评分等数据。
主要观察指标为手术部位感染、早期伤口失败（裂开）和未愈合伤口率。
组织密封切割组的伤口感染和裂开率显著较低（P=0.01 和 0.02），但手术时间明显较长（P<0.01）。电灼组未愈合伤口率为 12.5%，组织密封切割组为 4.7%（P=0.01）。当距肛门最低边缘 5cm 或更短时，组织密封切割组的伤口感染和裂开率较低（P<0.01 和 0.03）。
我们无法获得有关器械成本效益的数据。
在肛瘘手术中，组织密封切割装置比单极电灼更能促进伤口愈合。
