Huurman Eleonora A, den Otter A A Sophie, de Raaff Christel A L, van den Berg Rosaline, Baart Sara J, Wijnhoven Bas P L, Schouten Ruben, Furnée Edgar J B, Smeenk Robert M, Toorenvliet Boudewijn R
Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Colorectal Dis. 2024 Dec 5;27(1). doi: 10.1111/codi.17254.
The aim of this study was to assess Dutch surgical practice and outcomes for acute pilonidal abscess.
Patients with pilonidal sinus disease (PSD) who underwent surgical treatment between 1 March 2020 and 1 March 2021 at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with an acute abscess were included for analysis. Outcomes included symptoms, wound healing, time to resume daily activities and complications. Follow-up was 1 year and included questionnaires on recurrent abscesses, symptomatic chronic PSD, quality of life and patient-reported experience measures.
Of 681 included patients, 208 presented with an acute pilonidal abscess. Incision and drainage (I&D) was performed in 205 of these patients (99%). The wound healing rate after I&D was 42.2% at the outpatient clinic, with a median time to closure of 43 days. The complication rate was 4.4%. One-year questionnaires were completed by 158 out of 205 patients (77.1%). Fifteen patients (7.3%) had a recurrent abscess within 1 year. The symptomatic chronic PSD rate was 8.8%.
Of all the patients presenting with PSD in this prospective national study cohort, 30% had a pilonidal abscess. Incision and drainage showed a low complication rate but successful wound healing in less than half of the patients. The study showed that 91.2% of patients did not undergo additional surgical treatment for symptomatic chronic PSD within 1 year of follow-up.
本研究旨在评估荷兰急性藏毛窦脓肿的手术治疗情况及预后。
2020年3月1日至2021年3月1日期间，在36家参与研究的医院接受手术治疗的藏毛窦疾病（PSD）患者被纳入一项前瞻性观察队列研究。在本研究中，仅纳入急性脓肿患者进行分析。观察指标包括症状、伤口愈合情况、恢复日常活动的时间以及并发症。随访时间为1年，包括关于复发性脓肿、有症状的慢性PSD、生活质量和患者报告体验指标的问卷调查。
在纳入的681例患者中，208例表现为急性藏毛窦脓肿。其中205例（99%）患者接受了切开引流术（I&D）。门诊切开引流术后伤口愈合率为42.2%，中位愈合时间为43天。并发症发生率为4.4%。205例患者中有158例（77.1%）完成了1年的问卷调查。15例患者（7.3%）在1年内出现复发性脓肿。有症状的慢性PSD发生率为8.8%。
在这个全国性前瞻性研究队列中，所有表现为PSD的患者中，30%患有藏毛窦脓肿。切开引流术并发症发生率低，但不到一半的患者伤口成功愈合。研究表明，91.2%的患者在随访1年内未因有症状的慢性PSD接受额外的手术治疗。
