背景:骶尾部藏毛窦病(PSD)治疗有许多手术方法,范围从广泛的切除修复到病态较少的切除与原发性/皮瓣闭合。中线外襟翼,使切口线远离中线产裂,与传统的中线闭合技术相比,复发率较低。这项单盲随机对照试验旨在比较滑动摆动皮瓣技术与常规二次伤口闭合的短期/长期疗效和结果。
方法:本研究是一项对PSD患者进行的前瞻性随机对照试验。将患者分为两组:二次闭合(对照)和滑动摆动皮瓣(试验)。建议患者在手术后两周内每周两次访问外科诊所至少六个月。
结果:在这项研究中,纳入100例患者。他们被分成两组对照组,和审判。所有参与者的平均年龄为29.15±8.36岁(年龄范围:18-62岁)。两组平均手术时间为39.65±12.63,对照组为29.70±7.71,摆动皮瓣组为46.90±7.81。两组患者视觉模拟量表(VAS)评分显示,与接受二次闭合的患者相比,试验组的VAS评分较低(p值=0.006)。此外,试验组表现出更高的愈合率,更好的美容效果,与对照组相比,恢复时间更快。
结论:与二次闭合相比,滑动摆动皮瓣与出色的美容效果相关,疾病复发,和恢复时间。此外,术后并发症明显低于传统方法。
BACKGROUND: There are many surgical approaches for sacrococcygeal pilonidal sinus disease (PSD) therapy, ranging from wide excision repair to less morbid excisions with primary/flap closure. The off-midline flaps, which shift the incision line away from the midline natal cleft, have been associated with lower recurrence rates than the conventional mid-line closure techniques. This single-blinded randomized controlled trial aims to compare the short/long-term efficacy and outcome of the slide-swing flap technique with the conventional secondary wound closure.
METHODS: This study was a prospective randomized controlled trial conducted on patients with PSD. Patients were assigned into two groups: secondary closure (control) and slide-swing flap (trial). Patients were advised to visit the surgical clinic two times weekly for the two weeks after the operation for at least six months.
RESULTS: In this study, 100 patients were enrolled. They were assigned into two groups of control, and trial. The mean age of all participants was 29.15 ± 8.36 years old (age range: 18-62 years old). The mean operation time was 39.65 ± 12.63 for both groups, with the control group being 29.70 ± 7.71 and the swing flap group 46.90 ± 7.81. Patient visual analog scale (VAS) scores in both groups revealed that the trial group was associated with lower VAS scores compared with patients who underwent secondary closure (p-value = 0.006). Also, the trial group demonstrated a higher rate of healing, better cosmetic outcomes, and quicker recovery time compared with the controls.
CONCLUSIONS: Compared with secondary closure, the slide-swing flap was associated with excellent cosmetic outcomes, disease recurrence, and recovery time. Also, the post-operative complications were significantly lower compared with the traditional method.