Fahrni Gabriela Tonia, Vuille-Dit-Bille Raphael Nicolas, Leu Svenja, Meuli Martin, Staerkle Ralph Fabian, Fink Lukas, Dinçler Selim, Muff Brigitte Susanne
Department of Surgery, Hospital Bülach, Zürich, Switzerland.
Department of Surgery, Hospital Bülach, Zürich, Switzerland and Department of Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland.
Wounds. 2016 Jan;28(1):20-6.
The aim of the present study was to investigate the outcomes of different treatment options for acute and chronic pilonidal disease in a single large cohort of patients.
Four hundred and twenty-one consecutive patients (171 with chronic disease and 250 with acute abscess formation) who underwent surgery between 2003 and 2012 were included in the present study. Primary outcomes included symptomatic recurrence, time to wound healing, and time off from work. The median follow-up was 5.3 years.
In patients with acute abscess formation, the relapse rate was significantly higher (P = 0.0001) if they were treated with abscess excision (38.9%) compared with a wide local excision (13.3%). Time to relapse was significantly longer (P = 0.0205) in patients treated with wide local excision (median 7 vs 3 months), whereas time to wound healing and the days off from work were similar among groups. In chronic disease, the relapse rate was similar in patients treated with wide local excision followed by secondary wound healing (11.3%) when compared with patients treated with limited excision (27.6%) or wide excision with primary wound closure (26.8%). The time to wound healing was shortest in patients with primary wound closure following wide local excision, and the time off from work was not significantly different between groups.
Wide local excision with secondary wound healing seems to be the favorable operation method for acute and chronic pilonidal disease.
本研究旨在调查在一个大型患者队列中，急性和慢性藏毛疾病不同治疗方案的疗效。
本研究纳入了2003年至2012年间连续接受手术的421例患者（171例患有慢性疾病，250例形成急性脓肿）。主要结局包括症状复发、伤口愈合时间和误工时间。中位随访时间为5.3年。
在形成急性脓肿的患者中，与广泛局部切除（13.3%）相比，脓肿切除治疗后的复发率显著更高（P = 0.0001）（38.9%）。广泛局部切除治疗的患者复发时间显著更长（P = 0.0205）（中位时间7个月对3个月），而各组间伤口愈合时间和误工天数相似。在慢性疾病中，广泛局部切除后二期伤口愈合治疗的患者复发率（11.3%）与有限切除（27.6%）或广泛切除一期伤口闭合（26.8%）的患者相似。广泛局部切除后一期伤口闭合的患者伤口愈合时间最短，各组间误工时间无显著差异。
广泛局部切除并二期伤口愈合似乎是急性和慢性藏毛疾病的有利手术方法。
