PDF(Pubmed)
Abstract：
BACKGROUND: For patients with large and deep-seated recurrent complex pilonidal sinuses, the use of traditional open excision or flap reconstruction surgery may lead to high surgical difficulty, significant local damage, numerous complications, slow healing, and a high risk of recurrence. This article reports a case of recurrent complex pilonidal sinus and discusses the advantages of Bascom II combined with VSD treatment involving the preservation of tissue bridges.
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.
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.
摘要：
背景：对于大型和深层复发性复杂的藏毛窦患者，使用传统的开放切除或皮瓣重建手术可能导致较高的手术难度，重大局部损坏,许多并发症，缓慢愈合，而且复发的风险很高.本文报告了一例复发性复杂的藏毛窦，并讨论了BascomII结合VSD治疗涉及组织桥保存的优势。
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。
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。
