Saber Aly
Department of General Surgery, Port-Fouad General Hospital, Port-Fouad, Port-Said, Egypt.
N Am J Med Sci. 2014 May;6(5):210-4. doi: 10.4103/1947-2714.132936.
Numerous surgical procedures have been described for pilonidal sinus disease, but treatment failure and disease recurrence are frequent. Conventional off-midline flap closures have relatively favorable surgical outcomes, but relatively unfavorable cosmetic outcomes.
The author reported outcomes of a new simplified off-midline technique for closure of the defect after complete excision of the sinus tracts.
Two hundred patients of both sexes were enrolled for modified D-shaped excisions were used to include all sinuses and their ramifications, with a simplified procedure to close the defect.
The overall wound infection rate was 12%, (12.2% for males and 11.1% for females). Wound disruption was necessitating laying the whole wound open and management as open technique. The overall wound disruption rate was 6%, (6.1% for males and 5.5% for females) and the overall recurrence rate was 7%.
Our simplified off-midline closure without flap appeared to be comparable to conventional off-midline closure with flap, in terms of wound infection, wound dehiscence, and recurrence. Advantages of the simplified procedure include potentially reduced surgery complexity, reduced surgery time, and improved cosmetic outcome.
针对藏毛窦疾病已有多种手术方法被描述，但治疗失败和疾病复发很常见。传统的非中线皮瓣闭合术手术效果相对较好，但美容效果相对较差。
作者报告了一种新的简化非中线技术在完全切除窦道后闭合缺损的效果。
纳入200例患者，采用改良D形切除术以切除所有窦道及其分支，并采用简化程序闭合缺损。
总体伤口感染率为12%（男性为12.2%，女性为11.1%）。伤口裂开需要将整个伤口敞开并按开放技术处理。总体伤口裂开率为6%（男性为6.1%，女性为5.5%），总体复发率为7%。
就伤口感染、伤口裂开和复发而言，我们的无皮瓣简化非中线闭合术似乎与传统的有皮瓣非中线闭合术相当。简化手术程序的优点包括可能降低手术复杂性、缩短手术时间和改善美容效果。
