METHODS: The patient, a 31-year-old male, presented with recurrent swelling, pain, and purulent discharge from the sacrococcygeal region for over a year. Upon physical examination, extensive lumps and sinus tracts were observed in the lumbosacral tail area, with the lesion extending from L4 to the tip of the coccyx. Under general anesthesia, a segmental resection was performed, and the lumbosacral mass lesion was excised, preserving normal tissue bridges. The mature sinus tract at the upper part of the coccyx was removed, and Bascom II reconstruction surgery was performed. In the late stage at the site of lumbar sacral lesion excision, VSD was applied to promote wound healing.
CONCLUSIONS: The combination of Bascom II with lesion tunnel-like removal can reduce the damage, elevate gluteal cleft, and lower the recurrence rate. Subsequently, with the addition of VSD, it can accelerate the elimination of necrotic tissue, reduce infection risk, and expedite wound healing.
CONCLUSIONS: This case explores the advantages and characteristics of combining various techniques in the treatment of recurrent complex pilonidal sinuses, emphasizes the utility of VSD as an adjunctive therapy for large lesions.
方法:患者,一个31岁的男性,出现复发性肿胀,疼痛,骶尾部脓性分泌物超过一年。在体检时,广泛的肿块和窦道在腰骶尾部观察到,病变从L4延伸到尾骨尖端。在全身麻醉下,进行了节段性切除术,并切除了腰骶肿块,保留正常组织桥。尾骨上部的成熟窦道被切除,并进行了BascomII重建手术。在腰椎骶骨病变切除部位的晚期,应用VSD促进伤口愈合。
结论:将BascomII与病变隧道样去除相结合可以减少损伤,臀裂抬高,降低复发率。随后,随着VSD的加入,它可以加速坏死组织的消除,降低感染风险,加速伤口愈合.
结论:本病例探讨了多种技术结合治疗复发性复杂的藏毛鼻窦的优势和特点,强调VSD作为大病灶的辅助治疗的效用。