Sahsamanis Georgios, Samaras Stavros, Mitsopoulos Georgios, Deverakis Titos, Dimitrakopoulos Georgios, Pinialidis Dionysios
1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
Ann Med Surg (Lond). 2017 Feb 10;15:47-51. doi: 10.1016/j.amsu.2017.02.004. eCollection 2017 Mar.
Pilonidal sinus disease (PSD) is a highly debatable disorder regarding its surgical management, despite an assortment of surgical techniques described in the medical literature. The aim of this report is to provide an alternate semi-closed surgical method for treatment of PSD, with early recovery and a satisfactory cosmetic result.
In this retrospective study, 34 patients underwent surgical treatment for primary PSD; 32 male and 2 female. Patients were suffering from primary PSD, with the cyst located in the gluteal midline. Total excision of the cyst was performed, while the skin flaps were fixed on the postsacral fascia using absorbable sutures, leaving the wound semi-closed.
Technical success was 100%, with an average operation time of 48.7 ± 3.8 min. No wound dehiscence or infections were recorded postoperatively. One reoperation was performed due to hemorrhage. All patients were discharged on the day after surgery, with a VAS pain score of 1.3 ± 1. Two incidents of late wound dehiscence were recorded at 4th and 6th postoperative day due to strenuous exercise. Patients resumed their work after the 5th postoperative day with no complications. The 6 month follow up was completed in 29 patients, with a VAS cosmetic score of 8.1 ± 0.9. No recurrences were observed during the follow up period.
The presented semi-closed technique is a viable alternative for surgical management of PSD. It provides patients with a satisfying cosmetic result, while it allows for early and safe return to everyday activities with less pain experienced.
藏毛窦疾病（PSD）的手术治疗极具争议，尽管医学文献中描述了各种各样的手术技术。本报告的目的是提供一种用于治疗PSD的替代性半封闭式手术方法，以期实现早期康复并获得满意的美容效果。
在这项回顾性研究中，34例原发性PSD患者接受了手术治疗；其中男性32例，女性2例。患者患有原发性PSD，囊肿位于臀中线。对囊肿进行了完全切除，同时使用可吸收缝线将皮瓣固定于骶后筋膜上，使伤口保持半封闭状态。
技术成功率为100%，平均手术时间为48.7±3.8分钟。术后未记录到伤口裂开或感染情况。因出血进行了1次再次手术。所有患者均在术后次日出院，视觉模拟评分（VAS）疼痛评分为1.3±1。术后第4天和第6天因剧烈运动记录到2例晚期伤口裂开事件。患者术后第5天恢复工作，无并发症发生。29例患者完成了6个月的随访，VAS美容评分为8.1±0.9。随访期间未观察到复发情况。
所提出的半封闭式技术是PSD手术治疗的一种可行替代方法。它为患者提供了令人满意的美容效果，同时使患者能够早期、安全地恢复日常活动，且疼痛较轻。
