Iesalnieks Igors, Deimel Sina, Zülke Carl, Schlitt Hans J
Department of General and Visceral Surgery, Marienhospital Gelsenkirchen, Germany.
Department of Surgery, University Clinic of Regensburg, Germany.
J Dtsch Dermatol Ges. 2013 Oct;11(10):1001-5. doi: 10.1111/ddg.12140. Epub 2013 Aug 15.
Smoking has a negative impact on the natural history and on treatment results of many dermatological conditions. However, there are no data demonstrating a similar effect in patients with pilonidal disease.
Consecutive patients undergoing surgery for pilonidal disease between 1/2004 and 3/2012 were analyzed retrospectively. Two surgical methods were used: a minimally invasive "pit-picking" surgery for smaller primary disease and Karydakis flap for patients presenting with larger primary disease or those who have been operated previously. The aim of the present study was to analyze the impact of smoking on the natural history and on treatment results.
Six hundred and ten patients underwent 660 surgeries: 475 pit-picking operations and 185 Karydakis procedures. Smokers had developed a pilonidal abscess at least once during their disease significantly more often than non-smokers (48% vs. 26%, p = 0.00001). The recurrence rate following the pit-picking procedure was significantly increased in smokers (1-year recurrence rate: 36% vs. 21%, p = 0.008). After the Karydakis procedure, smokers developed more wound complications than non-smokers (29% vs. 10%, p = 0.005). The recurrence rate after the Karydakis flap was non-significantly increased in smokers (9% vs. 7% at 1 year, p = 0.07).
Smoking has a detrimental effect on the natural history and on treatment results of pilonidal disease. Patients should be encouraged to cease smoking prior to pilonidal surgery.
吸烟对许多皮肤病的自然病程和治疗效果有负面影响。然而，尚无数据表明藏毛疾病患者有类似影响。
回顾性分析2004年1月至2012年3月期间连续接受藏毛疾病手术的患者。采用了两种手术方法：对于较小原发性疾病采用微创“挖坑”手术，对于原发性疾病较大或既往接受过手术的患者采用Karydakis皮瓣手术。本研究的目的是分析吸烟对自然病程和治疗效果的影响。
610例患者接受了660次手术：475次挖坑手术和185次Karydakis手术。吸烟者在患病期间至少发生一次藏毛脓肿的频率明显高于非吸烟者（48%对26%，p = 0.00001）。吸烟者挖坑手术后的复发率显著增加（1年复发率：36%对21%，p = 0.008）。Karydakis手术后，吸烟者发生的伤口并发症比非吸烟者多（29%对10%，p = 0.005）。吸烟者Karydakis皮瓣手术后的复发率虽有增加但无统计学意义（1年时为9%对7%，p = 0.07）。
吸烟对藏毛疾病的自然病程和治疗效果有不利影响。应鼓励患者在藏毛手术前戒烟。
