Yildar Murat, Cavdar Faruk, Yildiz Mehmet Kamil
Department of General Surgery, Balıkesir University Medical School, Balıkesir, Turkey.
ScientificWorldJournal. 2013 Jun 17;2013:459147. doi: 10.1155/2013/459147. Print 2013.
The use of an S-type oblique excision with a bilateral gluteus maximus advancement flap has recently been described for the surgical treatment of sacrococcygeal pilonidal sinus (SPS). Its use in wide lesions has been limited due to the need for a full-thickness flap. We describe the use of an S-type oblique incision together with the Dufourmentel flap in wide lesions.
Twenty-one patients were treated using a technique including an S-shaped oblique excision of the sinus tract and a broad-pedicled full-thickness flap resembling a Dufourmentel flap to close the defect.
Of the 21 patients, 19 (90.5%) were male and 2 (9.5%) were female. Their mean age was 24.0 ± 6.1 (range 15-36) years. The mean follow-up period was 14.0 ± 5.8 (range 6-23) months. The postoperative complication rate was 4.8% (one patient), and recurrence was seen in one patient (4.8%). The mean return-to-work time was 13.5 ± 1.9 (range 10-18) days. None of the patients reported dissatisfaction with the cosmetic results.
This new technique achieved low morbidity and recurrence rates. We anticipate that this will become an important technique in the surgical treatment of SPS if the observed success is confirmed by randomized prospective trials.
最近有文献报道采用S型斜行切除联合双侧臀大肌推进皮瓣治疗骶尾部藏毛窦（SPS）。由于需要全厚皮瓣，其在广泛病变中的应用受到限制。我们描述了在广泛病变中使用S型斜切口联合杜福尔芒特尔皮瓣的方法。
采用一种技术治疗21例患者，该技术包括对窦道进行S形斜行切除，以及使用类似杜福尔芒特尔皮瓣的宽蒂全厚皮瓣来闭合缺损。
21例患者中，男性19例（90.5%），女性2例（9.5%）。他们的平均年龄为24.0±6.1岁（范围15 - 36岁）。平均随访期为14.0±5.8个月（范围6 - 23个月）。术后并发症发生率为4.8%（1例患者），1例患者出现复发（4.8%）。平均恢复工作时间为13.5±1.9天（范围10 - 18天）。所有患者均未对美容效果表示不满。
这项新技术实现了低发病率和复发率。如果观察到的成功结果能得到随机前瞻性试验的证实，我们预计这将成为SPS外科治疗中的一项重要技术。
