简介藏毛窦(PNS)是皮下组织中的小通道,在骶尾部区域最常见。就术后结果而言,决定PNS的最佳手术治疗对于外科医生来说仍然是一个挑战.预防疾病复发和改善生活质量可以被认为是治疗的主要目标。当前的研究旨在比较两种常用的PNS-菱形切除与Limberg皮瓣修复的手术治疗方法,以及通过二次意图治愈的大开放切除方法。方法在一项前瞻性随机研究中,将50例骶尾部PNS患者分为两组。A组采用菱形切除和Limberg皮瓣重建手术,B组采用大开放切除和二次意向愈合手术。数据是在专门设计的结构化形式上收集的,由患者的人口统计学组成,病史,介绍,和术后并发症评估为期6个月。感兴趣的比较结果是术后疼痛,术后焦虑,伤口愈合的持续时间,工作损失的持续时间,伤口感染的存在,和复发。结果在整个研究中观察到28岁的平均年龄与男性优势(76%)。A组术后早期疼痛的平均视觉模拟量表(VAS)评分较高,即,第1、3和7天。然而,B组患者在1个月和2个月时平均VAS评分为3±0和1±0,分别表明术后疼痛持续时间较长。在所有随访中,B组患者的术后焦虑/压力的焦虑VAS(VAS-A)评分也显着较高。A组的平均愈合时间为20±2天,B组为57±11天,差异有统计学意义。B组的工作损失持续时间也显著较高(31天)。B组5例患者出现伤口感染。在这项研究中,两组均未观察到复发。结论根据本研究的结果,Limberg皮瓣方法在愈合持续时间方面优于大开放切除方法,工作损失天数,术后疼痛,焦虑,和伤口感染。两种技术,然而,在复发方面具有可比性。
Introduction A
pilonidal sinus (PNS) is a small passageway in the subcutaneous tissue which develops most frequently in the sacrococcygeal area. In terms of postoperative outcomes, the decision on the best surgical treatment for PNS is still a challenge for a surgeon. Prevention of the disease recurrence and improving quality of the life can be considered primary goals of the treatment. The current study intends to compare two commonly practiced surgical treatments for PNSes-Rhomboid excision with Limberg flap repair against wide-open excision with healing by secondary intention. Methods In a prospective randomized study, 50 patients with sacrococcygeal PNS were divided into two groups. Group A was operated by rhomboid excision with Limberg flap reconstruction and Group B was operated by wide-open excision and healing by secondary intention. Data were collected on a specially designed structured proforma and consisted of patient demographics, medical history, presentation, and postoperative complications assessed for a period of 6 months. Comparative outcomes of interest were postoperative pain, postoperative anxiety, duration of wound healing, duration of work loss, presence of wound infection, and recurrence. Results Mean age of 28 years was observed across the study with a male preponderance (76%). The mean visual analog scale (VAS) score for pain was greater in Group A during the early postoperative period, i.e., days 1, 3, and 7. However, patients in Group B reported a mean VAS score of 3 ± 0 and 1 ± 0 at one month and 2 months, respectively indicating a longer duration of postoperative pain overall. Patients in Group B also reported a significantly higher VAS for anxiety (VAS-A) score for postoperative anxiety/stress in all the follow-up visits. The mean healing time was 20 ± 2 days in Group A and 57 ± 11 days in Group B showing a significant difference. Duration of work loss was also significantly higher in Group B (31 days). Five patients in Group B developed wound infections. No recurrence was observed across both the groups in this study. Conclusion According to the findings of this study, the Limberg flap method outperforms the wide-open excision approach in terms of healing duration, work loss days, postoperative pain, anxiety, and wound infection. Both the techniques, however, are comparable in terms of recurrence.