Department of Burn and Plastic Surgery, Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of General surgery, Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
Int Wound J. 2023 Aug;20(6):2241-2249. doi: 10.1111/iwj.14105. Epub 2023 Feb 19.
Pilonidal sinus disease (PNSD) challenged surgeons for decades. Limberg flap repair (LFR) is a common treatment for PNSD. The purpose of this study was to observe the effect and risk factors of LFR in PNSD. A retrospective study was conducted on the PNSD patients who visited two medical centers and four departments in the People's Liberation Army General Hospital and were taking LFR treatment between 2016 and 2022. The risk factors, the effect of the operation, and complications were observed. The effects of known risk factors on the surgical results were compared. There were 37 PNSD patients: male/female ratio of 35:2, average age: 25.1 ± 7.9 years. Average BMI: 25.2 ± 4.0 kg/m , average wound healing time: 15.4 ± 3.4 days. 30 patients (81.0%) healed in stage one and 7 (16.3%) had postoperative complications. Only 1 patient (2.7%) had a recurrence while others were healed after dressing-changing. There was no significant difference in age, BMI, preoperative debridement history, preoperative sinus classification, Wound area, Negative pressure drainage tube, prone time (<3d) and treatment effect. Squat defecate and premature defecation were associated with treatment effect, and they were independent predictors of treatment effect in the multivariate analysis. LFR has a stable therapeutic outcome. Compared with other skin flaps, the therapeutic effect of this flap is not significantly different, but the design is simple and is not affected by the known risk factors before operation. However, it is necessary to avoid the influence of two independent risk factors, squatting defecation and premature defecation, on the therapeutic effect.
藏毛窦疾病（PNSD）多年来一直困扰着外科医生。Limberg 皮瓣修复（LFR）是治疗 PNSD 的常用方法。本研究旨在观察 LFR 治疗 PNSD 的效果及相关风险因素。对 2016 年至 2022 年间在解放军总医院四个科室就诊并接受 LFR 治疗的 PNSD 患者进行回顾性研究，观察手术风险因素、手术效果及并发症等。比较已知风险因素对手术结果的影响。共纳入 37 例 PNSD 患者，男女比例为 35:2，平均年龄 25.1±7.9 岁，平均 BMI 为 25.2±4.0kg/m²，平均伤口愈合时间为 15.4±3.4 天。30 例（81.0%）患者一期愈合，7 例（16.3%）术后出现并发症，仅 1 例（2.7%）复发，余患者经换药后均愈合。年龄、BMI、术前清创史、术前窦道分类、创面面积、负压引流管、俯卧位时间（<3d）及治疗效果在两组间差异均无统计学意义。蹲位排便、过早排便与治疗效果有关，多因素分析提示二者为治疗效果的独立预测因素。LFR 治疗效果稳定，与其他皮瓣相比，该皮瓣治疗效果无明显差异，且设计简单，不受术前已知风险因素的影响，但需要避免蹲位排便和过早排便这两个独立风险因素对治疗效果的影响。
