Department of Visceral Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 121, Geneva 14, Switzerland.
Service de Chirurgie Digestive, Générale et Endocrinienne, CHU de Limoges, Hôpital Dupuytren, 87042, Limoges Cedex, France.
BMC Surg. 2021 Apr 17;21(1):197. doi: 10.1186/s12893-021-01204-4.
Surgical wound infection contributes to prolonged recovery time after pilonidal sinus excision. As a standard procedure after surgery, we recommend our patients to perform water irrigations in the intergluteal cleft 4 to 6 times a day during the post-operative period. Our hypothesis is that this should reduce healing time and complication rates. The aim of this study was to measure the importance of sacro coccygeal hygiene in the management of pilonidal sinus disease.
We retrospectively collected data after surgical management of pilonidal sinus (sinusectomy procedures) in our division over a 10-year period. Patients were divided into three groups according to their local hygiene during postoperative follow-up and scored one (G1: good hygiene) to three (G3: poor hygiene). Primary outcome was complication rates. Secondary endpoints were, healing time, follow-up, time off work, and recurrence rate.
In G1 (N = 112), complication rate was 3.6%. In G2 (N = 109), it was 5.5%, whereas in G3 (N = 71), it reached 7.03%. However, there were no statistically significant differences between hygiene groups regarding complication rates in both univariate and multivariable analysis. Regarding secondary outcomes, there were significant differences between hygiene groups concerning median follow-up (p = 0.0001) and median time off work (p = 0.0127).
Good hygiene of wound is essential for optimal, rapid healing without complications. The importance of this report is to show that thanks to our hygiene follow-up strategy with frequent perineal irrigations and regular follow-up checks, patients with at a first glance "unclean local conditions", reached similar complications, median healing time and recurrences rates to patients with medium and good wound hygiene level.
切口感染会延长肛门部藏毛窦切除术后的康复时间。作为手术后的标准程序，我们建议患者在术后期间每天在臀部裂之间进行 4 到 6 次水冲洗。我们的假设是这将减少愈合时间和并发症发生率。本研究的目的是测量骶尾部卫生在肛门部藏毛窦疾病管理中的重要性。
我们回顾性地收集了我们科室在过去 10 年期间接受肛门部藏毛窦（窦切除术）手术治疗的患者数据。根据术后随访期间的局部卫生情况，患者被分为三组，并进行 1 到 3 分的评分（G1：良好卫生；G2：中等卫生；G3：不良卫生）。主要结果是并发症发生率。次要终点是愈合时间、随访时间、休假时间和复发率。
G1 组（N=112）的并发症发生率为 3.6%。G2 组（N=109）为 5.5%，G3 组（N=71）为 7.03%。然而，在单因素和多因素分析中，卫生组之间的并发症发生率均无统计学差异。在次要结果方面，卫生组之间的中位随访时间（p=0.0001）和中位休假时间（p=0.0127）存在显著差异。
良好的伤口卫生对于无并发症的最佳快速愈合至关重要。本报告的重要意义在于表明，由于我们采用了频繁的会阴冲洗和定期随访检查的卫生随访策略，即使患者的局部卫生条件看起来“不干净”，他们的并发症发生率、中位愈合时间和复发率与中等到良好伤口卫生水平的患者相似。
