Lasithiotakis Konstantinos, Aghahoseini Assad, Volanaki Dimitra, Peter Mark, Alexander David
Department of General Surgery, York Teaching Hospital NHS Foundation Trust, York, UK.
Department of General Surgery, York Teaching Hospital NHS Foundation Trust, York, UK.
J Surg Res. 2018 Mar;223:123-127. doi: 10.1016/j.jss.2017.09.051. Epub 2017 Nov 17.
The traditional open incision and drainage of a pilonidal abscess is associated with slow healing and delayed return to normal daily activities. The aim of this study is to assess safety, effectiveness, and patient satisfaction of aspiration followed by antibiotics for a pilonidal abscess.
All patients presenting with an acute pilonidal abscess during the period December 2010 and December 2014 in York Hospital, UK, were treated with bedside aspiration under local anesthetic, followed by oral cefalexin and metronidazole for 7 days. Patients with immunosuppression, diabetes, overlying skin necrosis, and perforation were excluded. Complications of the procedure were prospectively recorded. Long-term outcomes and overall patients' satisfaction were assessed with the use of mailed questionnaires and Visual Analogue Scales (VAS) (0 = not satisfied at all, 10 = very satisfied).
One hundred sixty-nine patients presented with an acute pilonidal abscess and a total of 100 patients were treated with aspiration and antibiotics. There were 50 women (50%) and the median (interquartile range [IQR]) age of the cohort was 24 (14) years. Eleven patients had a history of a previous pilonidal procedure. Seven patients were treated successfully with a reaspiration. Overall, 10 patients required incision and drainage after a median (IQR) follow-up time of 29 (47) months. Fifty-six patients returned completed questionnaires. The median (IQR) of the VAS for the overall satisfaction of the procedure was 9 (5).
Aspiration of a pilonidal abscess in selected patients is effective in 83%, and it is associated with high overall satisfaction rates.
传统的开放性切开引流术治疗藏毛窦脓肿愈合缓慢，恢复正常日常活动延迟。本研究旨在评估抽吸联合抗生素治疗藏毛窦脓肿的安全性、有效性和患者满意度。
2010年12月至2014年12月期间，英国约克医院所有出现急性藏毛窦脓肿的患者均在局部麻醉下进行床边抽吸，随后口服头孢氨苄和甲硝唑7天。排除免疫抑制、糖尿病、皮肤坏死和穿孔的患者。前瞻性记录手术并发症。通过邮寄问卷和视觉模拟量表（VAS）（0=完全不满意，10=非常满意）评估长期结果和患者总体满意度。
169例患者出现急性藏毛窦脓肿，共100例患者接受了抽吸和抗生素治疗。有50名女性（50%），该队列的年龄中位数（四分位间距[IQR]）为24（14）岁。11例患者有既往藏毛窦手术史。7例患者再次抽吸治疗成功。总体而言，10例患者在中位（IQR）随访时间29（47）个月后需要切开引流。56例患者返回了完整问卷。该手术总体满意度的VAS中位数（IQR）为9（5）。
对选定患者进行藏毛窦脓肿抽吸术的有效率为83%，总体满意度较高。
