Ahmad Mahfouz S I, Eltayeb Hazem
Plastic Surgery Department, Zagazig University, Egypt.
Al-Adan Hospital-Ministry of Health, Kuwait.
Plast Reconstr Surg Glob Open. 2020 Dec 18;8(12):e2901. doi: 10.1097/GOX.0000000000002901. eCollection 2020 Dec.
Pilonidal sinus is a chronic recurrent medical disease. The exact etiology of the disease is still unknown, but the most accepted theory is an acquired condition characterized by infected sinus in the natal cleft area containing a lifeless hair tuft. Multiple techniques were prescribed for its treatment; however, the ideal method is not yet defined.
The study population includes 58 male patients who underwent excision of their recurrent pilonidal sinus, and the resulting defects were reconstructed using combined horizontal split gluteus maximus flaps and rhomboid flaps. Outcomes were revised from patient case files and followed up in our outpatient clinic and via questionnaires.
The mean hospital stay was 3 days. The mean time to return to work was 16 days. Partial wound dehiscences occurred in 2 patients. Distal end flap necrosis occurred in 1 patient. There were no flap losses, no recurrences, no infections, no loss of function, and no seromas during a mean follow-up period of 24 months. All patients were satisfied with the results.
This technique has an operative time and hospital stays comparable to those of other techniques. It has minimal and acceptable complication rates and no recurrences. We can conclude that this procedure of combined split gluteus maximus muscle flap and rhomboid flap provides an excellent, effective, easy, and feasible method of choice for reconstructing defects of recurrent pilonidal sinus disease.
藏毛窦是一种慢性复发性疾病。该疾病的确切病因尚不清楚，但最被认可的理论是一种后天性疾病，其特征为在包含无活力毛簇的臀裂区域出现感染性窦道。针对其治疗采用了多种技术；然而，理想的方法尚未确定。
研究人群包括58例接受复发性藏毛窦切除术的男性患者，使用联合水平劈开臀大肌皮瓣和菱形皮瓣修复由此产生的缺损。结果从患者病历中进行修订，并在我们的门诊诊所通过问卷调查进行随访。
平均住院时间为3天。平均重返工作时间为16天。2例患者出现部分伤口裂开。1例患者发生远端皮瓣坏死。在平均24个月的随访期内，无皮瓣丢失、无复发、无感染、无功能丧失且无血清肿。所有患者对结果均满意。
该技术的手术时间和住院时间与其他技术相当。其并发症发生率极低且可接受，无复发情况。我们可以得出结论，这种联合劈开臀大肌肌皮瓣和菱形皮瓣的手术方法为复发性藏毛窦疾病缺损的修复提供了一种出色、有效、简便且可行的选择方法。
