背景:鼻窦病(PSD),慢性炎症性疾病,影响骶尾部软组织,尤其是年轻人。PSD的理想治疗仍然存在分歧。这项研究评估了简化的改良Limberg皮瓣结合真空辅助闭合治疗PSD的应用。
方法:这项前瞻性研究于2017年6月1日至2022年3月31日在长海医院进行,海军军医大学,上海,中国。该研究包括88名男性患者(91.7%)和8名女性患者(8.3%)。96例患者年龄在15至34岁之间(平均值±SD,23±4.4)。在全身麻醉下,所有患者均接受简化的改良Limberg皮瓣重建,并采用真空辅助闭合.病人的体重,手术时间,拔管时间,住院,恢复正常生活或工作的时间,伤口感染,记录伤口裂开和复发率。视觉模拟量表(VAS)评分和温哥华瘢痕评分用于对患者的疼痛和手术区域的疤痕进行评分。
结果:切除的病变组织的体积为13.5-120(平均值±SD,34.993±24.406)cm2。治疗期间平均手术时间为97.68±18.72min,平均拔管时间为(6.36±1.55)天,平均住院时间为19.4天;没有患者失访.所有患者均未出现术后复发,伤口感染,血清或血肿。六名患者(6.3%)在出生裂隙周围的皮瓣尖端出现伤口裂开。恢复日常活动的平均时间为26.3天。平均VAS疼痛评分为(6.00±1.53)分,温哥华疤痕平均得分为(5.96±1.51)分,12例(12.5%)患者对其美学效果不满意,美容满意度平均得分为(6.64±1.28)分。
结论:真空辅助闭合手术简化改良Limberg皮瓣重建是治疗PSD的有效创新方法,复发率低,恢复快。
BACKGROUND: Pilonidal sinus disease (PSD), a chronic inflammatory disease, affects the sacrococcygeal soft tissue, especially in young adults. The ideal treatment for PSD remains divergence. This study evaluated the application of a simplified modified Limberg flap combined with vacuum-assisted closure for treating PSD.
METHODS: This prospective study was conducted from 1 June 2017 to 31 March 2022 in Changhai Hospital, Naval Military Medical University, Shanghai,
China. The study included 88 male patients (91.7%) and 8 female patients (8.3%). The 96 patients ranged in age from 15 to 34 years (mean ± SD, 23 ± 4.4). Under general anaesthesia, all patients underwent simplified modified Limberg flap reconstruction with vacuum-assisted closure. The patient\'s weight, surgical time, extubation time, hospital stay, time to return to normal life or work, wound infection, wound dehiscence and recurrence rate were recorded. The visual analogue scale (VAS) score and the Vancouver scar score were used to score patients\' pain and scars in the surgical area.
RESULTS: The volume of resected diseased tissue was 13.5-120 (mean ± SD, 34.993 ± 24.406) cm2 . The average surgical time during the treatment period was 97.68 ± 18.72 min, and the average extubation time was (6.36 ± 1.55) days, the mean hospital stay was 19.4 days; no patients were lost to follow-up. None of the patients experienced post-operative recurrence, wound infection, seroma or hematoma. Six patients (6.3%) experienced wound dehiscence at the flap tip around the natal cleft. The mean time to the resumption of daily activities was 26.3 days. The average VAS pain score was (6.00 ± 1.53) points, and the average Vancouver scar score was (5.96 ± 1.51) points, 12 patients (12.5%) were dissatisfied with their aesthetic results, and the average beauty satisfaction score is (6.64 ± 1.28) points.
CONCLUSIONS: Simplified modified Limberg flap reconstruction with vacuum-assisted closure surgery is an effective and innovative method for the treatment of PSD, with a low recurrence rate and rapid recovery.