al-Hassan H K, Francis I M, Neglén P
Department of Surgery, Kuwait University.
Acta Chir Scand. 1990 Oct;156(10):695-9.
Two methods for treatment of chronic pilonidal disease were compared in a randomised trial of 100 patients with a mean follow-up of 29 months. Four patients were excluded from the excision and closure group, leaving 96 patients for analysis. Initial primary healing was significantly more frequent after excision and primary closure (45/46; 98%) compared with excision and healing by secondary granulation (36/50; 72%). The mean healing time was significantly shorter in the excision and closure group (10.3 days) compared to the excision and granulation group (13 weeks). There was, however, no significant difference between the two groups in cure rate after the first operation. The recurrence rate in the excision and granulation group was 12% and after primary closure 20%. The presence of stiff hair and anaerobic bacteria were related to the failure of primary healing, but not associated with recurrence. Although the cure rate was the same regardless which operation was done, the primary healing was quicker and the healing time and duration of sick-leave were shorter after primary closure. Excision with primary closure therefore seems to be the preferable method.
在一项针对100例患者的随机试验中，对两种治疗慢性藏毛窦疾病的方法进行了比较，平均随访时间为29个月。切除并缝合组有4例患者被排除，剩余96例患者用于分析。与切除并二期肉芽愈合相比，切除并一期缝合后初始一期愈合明显更常见（45/46；98%对比36/50；72%）。切除并缝合组的平均愈合时间（10.3天）明显短于切除并肉芽愈合组（13周）。然而，两组首次手术后的治愈率无显著差异。切除并肉芽愈合组的复发率为12%，一期缝合后的复发率为20%。硬毛和厌氧菌的存在与一期愈合失败有关，但与复发无关。尽管无论进行哪种手术治愈率相同，但一期缝合后一期愈合更快，愈合时间和病假时长更短。因此，一期缝合切除术似乎是更可取的方法。
