Driouch Jamal, Braumann C, Dehnst J, Ikram M, Alnammous G, Bausch D, Glatz T
Chirurgische Klinik - Allgemein- und Viszeralchirurgie, Gefäßchirurgie, Marien Hospital Herne - Universitätsklinikum, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
Klinik für Chirurgie, St. Josef Hospital Bochum, Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Deutschland.
Chirurg. 2022 Feb;93(2):182-189. doi: 10.1007/s00104-021-01439-0. Epub 2021 Jun 16.
A number of different treatment algorithms are recommended for the treatment of an acute pilonidal abscess and a chronic pilonidal sinus. While a 1-stage surgical procedure using excision or plastic reconstruction according to Limberg or Karydakis is suggested for chronic pilonidal sinus, a 2‑stage procedure is recommended for an acute pilonidal abscess. The aim of this study was to compare the results of the 1‑stage surgery with plastic reconstruction according to Limberg for acute pilonidal abscess and chronic pilonidal sinus in terms of recurrence, disorders of wound healing, inpatient length of stay and patient satisfaction.
From 2009 to 2014 a total of 39 patients were included in this prospective observational study: 21 patients with acute pilonidal abscess and 18 patients with chronic pilonidal sinus. All patients were surgically treated with a 1‑stage procedure using the Limberg flap method. The groups were compared in terms of postoperative complication rates and frequency of recurrence.
Both groups were basically comparable with respect to demographic characteristics and risk factor profiles. Analysis of the postoperative results showed a comparable rate of postoperative wound healing disorders (10% vs. 17%, p = 0.647). In the group with acute pilonidal abscesses there was no recurrence during the observational period, while in the chronic pilonidal sinus group there were 2 (11%) recurrences (p = 0.206).
The results of the Limberg flap procedure regarding acute pilonidal abscesses were comparable to those of chronic pilonidal sinus. The results of this study show a trend to a lower risk of recurrence. The use of the Limberg flaps therefore also seems to be an adequate treatment option in an acute infection situation.
对于急性藏毛窦脓肿和慢性藏毛窦的治疗，推荐了多种不同的治疗方案。对于慢性藏毛窦，建议采用根据林贝格（Limberg）或卡里达基斯（Karydakis）方法进行切除或整形重建的一期手术，而对于急性藏毛窦脓肿则推荐采用二期手术。本研究的目的是比较一期手术联合林贝格整形重建治疗急性藏毛窦脓肿和慢性藏毛窦在复发率、伤口愈合障碍、住院时间和患者满意度方面的结果。
2009年至2014年，共有39例患者纳入本前瞻性观察研究：21例急性藏毛窦脓肿患者和18例慢性藏毛窦患者。所有患者均采用林贝格皮瓣法进行一期手术治疗。比较两组术后并发症发生率和复发频率。
两组在人口统计学特征和危险因素方面基本具有可比性。术后结果分析显示，术后伤口愈合障碍发生率相当（10%对17%，p = 0.647）。在急性藏毛窦脓肿组观察期内无复发，而慢性藏毛窦组有2例（11%）复发（p = 0.206）。
林贝格皮瓣手术治疗急性藏毛窦脓肿的结果与慢性藏毛窦相当。本研究结果显示复发风险有降低趋势。因此，在急性感染情况下，使用林贝格皮瓣似乎也是一种合适的治疗选择。
