Zhou Changkai, Wang Lu, Wang Qianqian, Xiang Tie
From the Department of Burn and Plastic Surgery, Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China.
Plast Reconstr Surg Glob Open. 2025 Sep 23;13(9):e7140. doi: 10.1097/GOX.0000000000007140. eCollection 2025 Sep.
Pilonidal sinus (PS) is a chronic condition primarily affecting young adult men and characterized by recurrent abscess formation, discharge, and significant physical and psychosocial impacts. Traditional surgical methods, including basic Z-plasty, often fail to adequately address horizontal tension, leading to high recurrence and complication rates. This pilot study evaluated the efficacy of lateralized Z-plasty (LZP) for reducing horizontal wound tension and improving postoperative outcomes.
We conducted a retrospective review of patients presenting with sacrococcygeal PS who underwent LZP repair at our hospital. A 2-stage surgical approach involving precise sinus excision followed by reconstruction with LZP was used. The flap design incorporated a central limb oriented laterally, creating triangular flaps that were transposed to reduce tension. The outcomes assessed included complications, recurrence, and patient satisfaction.
Between September 2023 and March 2025, 14 consecutive patients who underwent 15 LZP procedures were included in this study. No cases of flap necrosis, hematoma, seroma, or infection were observed. The mean hospital stay was 14.1 days (range, 9-22 d), with a mean follow-up of 6.2 months (range, 2-18 mo). One patient experienced delayed wound healing, and 1 experienced recurrence, which was managed with contralateral LZP. All patients expressed satisfaction with their postoperative appearance.
The modified LZP technique shows promise as an effective alternative for PS treatment, offering reduced complications and improved functional and aesthetic outcomes, with potential for further optimization.
藏毛窦（PS）是一种主要影响年轻成年男性的慢性疾病，其特征为反复形成脓肿、有分泌物排出，并对身体和心理社会产生重大影响。包括基本Z成形术在内的传统手术方法往往无法充分解决水平张力问题，导致高复发率和并发症发生率。本前瞻性研究评估了侧方Z成形术（LZP）在减轻伤口水平张力和改善术后结果方面的疗效。
我们对在我院接受LZP修复术的骶尾部藏毛窦患者进行了回顾性研究。采用两阶段手术方法，先精确切除窦道，然后用LZP进行重建。皮瓣设计包括一个向外侧的中央肢体，形成三角形皮瓣，将其移位以减轻张力。评估的结果包括并发症、复发情况和患者满意度。
在2023年9月至2025年3月期间，本研究纳入了14例连续接受15次LZP手术的患者。未观察到皮瓣坏死、血肿、血清肿或感染病例。平均住院时间为14.1天（范围9 - 22天），平均随访6.2个月（范围2 - 18个月）。1例患者伤口愈合延迟，1例复发，对侧行LZP处理。所有患者对术后外观均表示满意。
改良LZP技术有望成为治疗藏毛窦的有效替代方法，并发症减少，功能和美学效果改善，具有进一步优化的潜力。
