Orhalmi J, Sotona O, Dušek T, Ferko A
Rozhl Chir. 2014 Oct;93(10):491-5.
Pilonidal sinus is a skin disease affecting the sacrococcygeal region caused by chronic irritation of the skin by ingrowing hairs that get pushed into skin sinuses and follicles. The acute form of the disease which is presented by subcutaneous abscesses very often develops into chronic suppurative subcutaneous fistula. The incidence of pilonidal sinus is approximately 26/100,000 people. Radical surgical excision using skin flaps is essential for successful treatment.
The results of surgical treatment were analysed retrospectively. All surgical procedures evaluated were performed at the Department of Surgery, University Hospital in Hradec Kralove, from January 2010 to June 2014. The parameters analysed were gender, age, method used to close the defect, length of hospital stay, overall morbidity including pilonidal sinuses recurrence.
141 patients undergoing radical excision for pilonidal sinus were analysed. Primary suture was used in 101 (71.6%) patients. Limberg flap reconstruction was performed in 16 (11.3%) patients and Karydakis procedure was used in 24 (17.0%) patients. The length of hospital stay was 4.2 days. 19 operations were performed for recurrent pilonidal sinus. Norecurrence occurred after Karydakis procedure, there were 3 cases of recurrence after Limberg flap reconstruction, and 8 patients experienced recurrence after primary suture. The overall incidence of recurrence was 7.8%. Surgical site complications were recorded mostly after primary suture (37 patients, 26.2%). Conversely, surgical site complications appeared in the Limberg flap group in 2 patients (12.5%) and in theKarydakis procedure group in 1 patient (4.2%).
Limberg flap reconstruction and Karydakis procedure lead to better results in pilonidal sinus surgery, especially as regards lower recurrence rates and overall morbidity. Both of these procedures are relatively easy to perform and technically undemanding.
藏毛窦是一种影响骶尾部区域的皮肤病，由向内生长的毛发对皮肤造成慢性刺激所致，这些毛发会被挤入皮肤窦道和毛囊。该疾病的急性形式表现为皮下脓肿，常发展为慢性化脓性皮下瘘管。藏毛窦的发病率约为每10万人中有26例。采用皮瓣进行根治性手术切除是成功治疗的关键。
对手术治疗结果进行回顾性分析。所有评估的外科手术均于2010年1月至2014年6月在赫拉德茨克拉洛韦大学医院外科进行。分析的参数包括性别、年龄、关闭缺损所采用的方法、住院时间、总体发病率（包括藏毛窦复发）。
对141例行藏毛窦根治性切除术的患者进行了分析。101例（71.6%）患者采用了一期缝合。16例（11.3%）患者进行了Limberg皮瓣重建，24例（17.0%）患者采用了Karydakis手术。住院时间为4.2天。因复发性藏毛窦进行了19次手术。Karydakis手术后未出现复发，Limberg皮瓣重建后有3例复发，一期缝合后有8例患者复发。总体复发率为7.8%。手术部位并发症大多记录于一期缝合后（37例患者，26.2%）。相反，Limberg皮瓣组有2例患者（12.5%）出现手术部位并发症，Karydakis手术组有1例患者（4.2%）出现手术部位并发症。
Limberg皮瓣重建和Karydakis手术在藏毛窦手术中效果更佳，尤其是在降低复发率和总体发病率方面。这两种手术相对容易实施，技术要求不高。
