Showing 3 results for Pilonidal Sinus
Haji Barati B, Ghafuri A,
Volume 68, Issue 9 (12-2010)
Abstract
Background: Gross difference in return to work exists in pilonidal
sinus patients operated by primary and secondary repair. This survey was to
evaluate the results of surgical management of pilonidal sinus with primary or
secondary closure.
Methods: In a randomized clinical
trial, patients with pilonidal sinus referring to the surgical clinic of Shariati
Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either
excision with midline closure (primary, n=40), or excision without closure (secondary, n=40). The recorded outcomes were
hospital stay, healing time, time off work, postoperative pain, patient's
satisfaction and the recurrence rate.
Results: Majority of the patients were
male (87.50%). There was no significant
difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001) and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001) were shorter in primary
group but, there were no significant differences in hospital stay and number
of visits. Intensity of postoperative pain in the 1st (37.75±6.5 Vs. 43.63±5.06, p=0.001), 2nd (26.75±6.66 Vs. 34.63±5.48, p=0.001), 3rd (18.25±6.05 Vs. 27.88±6.88, p=0.001), and 7th (8.45±3.85 Vs. 17.88±6.19, p=0.001) days were lower in primary
closure group. There was not significant difference in complication rates in
groups. Patients' satisfaction was higher in primary group (4.15±0.53 Vs. 3.6±0.5, p=0.001).
Conclusion: According to this study excision and primary
closure is the preferred procedure in patients with pilonidal sinus. It has the
advantages of shorter time off work earlier wound healing, lesser
postoperative pain, higher patients satisfaction and comparable complication
and recurrence rates with excision and open wound.
Amir Keshvari , Mohammad-Sadegh Fazeli , Alireza Kazemeni , Alipasha Meisami , Mohammad-Kazem Nouri-Taromloo,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Sacrococcygel region is the most common site for pilonidal sinus and surgery is the most common treatment for it. Numerous operative techniques have been described for management of this disease but a technique with low recurrence and complication rates is the best treatment option. Karydakis has been introduced as a method with less recurrence rate, but it seems that surgeons debate on complications and it is not a common technique in our country. In this article, we will discuss Karydakis procedure and its results after a prospective follow-up in our patients.
Methods: This is a prospective single cohort study on the patients with sacrococcygeal pilonidal disease. Cases evaluated in this study included patients underwent Karydakis procedure for their pilonidal sinus from 23 September 2006 to 22 September 2013. Patients were followed-up prospectively after their discharge within the first week, first month and third month for early complications and then annually for recurrence. The length of follow-up ranged from 3 to 77 months (median 36 months).
Results: Of 141 patients, 119 (84.4%) were male and mean operating time was 55.52 (35-120) minutes. Mean time to healing wound with no need to dressing was 15.92 (range: 2-120) days and mean time to return to work was 14.44 (range, 1-35) days. Overall rate of early post-operative complications was 21.3% that most of them treated conservatively. Wound breakdown within the caudal part was the most common complication detected in 12.1% of patients and infection was detected in 5.8%. Hematoma, seroma and complete wound breakdown were seen in one patient each. The mean score of patient's satisfaction after one year was 4.91 out of 5. Recurrence was appeared in 1.42% of patients.
Conclusion: Karydakis procedure for sacrococcygeal pilonidal disease is associated with low complications, short healing time and return to work, and reasonable recurrence rate.
Shaban Mehrvarz , Hassan Ali Mohebbi , Shahram Manoochehry , Saied Arjmand , Hamid Reza Rasouli ,
Volume 76, Issue 10 (1-2019)
Abstract
Background: Sacrococcygeal pilonidal disease (PD) is prevalent in the young adults. The cause of PD is unclear, and there are different surgical procedures for the treatment. The Pilonidal sinus disease is an unpleasant, chronic relapsing condition that is difficult to cure. There is a wide variety of surgical treatments with sub-optimal results for it. The ideal treatment for the pilonidal sinus disease has yet to be defined. There are many surgical approaches described in the literature. In this study, the long-term outcomes of four current surgical methods for PD were evaluated and compared. We aimed to assess recurrence, satisfaction, complications rate and wound healing time in the four current surgical methods for PD.
Methods: This cross-sectional study was conducted in the Department of Surgery at the Baqiyatallah University Hospital, Tehran, Iran, from April 2017 to September 2017. The study was carried out on 182 postoperative patients. Surgeries were performed in different methods such as; open, closed, semi-closed and limited excision. Diabetics, obese patients and patients with acute pilonidal abscess or prior PD surgery were excluded. All patients were followed for at least three years after surgery. During the follow -up period, patients were assessed for recurrence, satisfaction, complications rate and wound healing time. The outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires.
Results: In this study forty-four patients were operated via closed Method, 48 patients through open, 48 via semi-closed and 42 one's trough limited excision methods. The highest rate of recurrence was in the open group. There were no cases of recurrence in the closed group. There were also less postoperative hemorrhage and faster wound healing in the closed group. The average satisfaction of all patients was 88.9±8.7. The mean satisfaction rate in the closed group was 95.9±5.3 which was higher than other groups.
Conclusion: The results of this study demonstrated that in the non-recurrent cases of sacral pilonidal sinus, complete Excision and primary repair have fewer complications and shows higher satisfaction rate.
