Borel F, Gaudin C, Duchalais E, Lehur P-A, Meurette G
Clinique de chirurgie digestive et endocrinienne, CHU Hôtel-Dieu, Nantes, France.
Clinique de chirurgie digestive et endocrinienne, CHU Hôtel-Dieu, Nantes, France.
J Visc Surg. 2017 Dec;154(6):407-412. doi: 10.1016/j.jviscsurg.2017.02.004.
To assess the impact of a simple flap closing procedure by Karydakis flap (KF) after pilonidal sinus excision on the costs and healing time as compared to routine lay-open technique.
Out of 44 consecutive patients operated on for pilonidal excision (November 2013-March 2015), 17 had a Karydakis flap and 27 a lay-open procedure. For each patient, the length of stay, the operating time (OT), the time needed for complete healing and postoperative care resources were recorded. The global costs included OT, nursing care quantity, and modalities until complete scar healing.
One reoperation in the lay-open group was necessary during the follow-up (8±5months). No recurrence occurred. Postoperative morbidity was similar in both groups. Results showed that KF global cost was inferior as compared to lay-open technique (941±178€ vs. 1601±399€; P=0.0001), KF healed faster (32±17 vs. 59±22days; P=0.0001), whereas OT was longer in KF group (16±7 vs. 25±4min; P=0.001).
KF allows a faster healing time and a 41% lower cost than lay-open technique. Preferential use of KF rather than lay-open procedure could allow a significant health cost saving.
评估与常规敞开技术相比，藏毛窦切除术后采用Karydakis皮瓣（KF）简单皮瓣闭合手术对成本和愈合时间的影响。
在44例连续接受藏毛窦切除术的患者（2013年11月至2015年3月）中，17例行KF手术，27例行敞开手术。记录每位患者的住院时间、手术时间（OT）、完全愈合所需时间和术后护理资源。总体成本包括OT、护理量以及直至完全瘢痕愈合的方式。
随访期间（8±5个月），敞开手术组有1例需要再次手术。无复发发生。两组术后发病率相似。结果显示，与敞开技术相比，KF的总体成本更低（941±178欧元对1601±399欧元；P = 0.0001），KF愈合更快（32±17天对59±22天；P = 0.0001），而KF组的OT更长（16±7分钟对25±4分钟；P = 0.001）。
与敞开技术相比，KF可实现更快的愈合时间且成本降低41%。优先使用KF而非敞开手术可显著节省医疗成本。
