Comparative analysis of the same technique-the same surgeon approach in the surgical treatment of pilonidal sinus disease: a retrospective cohort study

Köse, Emin; Hasbahçeci, Mustafa; Tonyali, Hasan; Karagulle, Muslum

doi:10.4174/astr.2017.93.2.82

Cited by 14 publications

(14 citation statements)

References 23 publications

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“…at riskRR in % (95% CI)Nr. at riskPrimary open (143)2.7* (0.0–5.5)143*5.9* (1.4–10.4)120*NANANANA 32, 114, 118 Primary median closure (2902)0.8 (0.4–1.1)28187.0* (5.7–8.2)1383*18.8* (15.7–21.8)417*NANA 118, 127, 133, 136, 137, 139, 143, 148, 149, 158– 160, 169, 172– 174, 183, 192, 199– 201, 232, 242, 243, 246, 247, 597– 603 Primary asymmetric closure (727)1.7 (0.7–2.8)6212.5 (1.1–3.8)4037.4 (4.4–10.4)257NANA 183, 192, 253, 259, 261, 262 Karydakis/Bascom (2471)0.8 (0.4–1.1)23561.7* (1.1–2.4)1343*10.7 (7.4–13.9)257NANA 133, 172, 192, 199, 200, 262, 264, 267, 268, 270, 273, 274, 276, 279, 282, 284, 289– 292, 295, 296, 300, 305– 309, 603 Limberg/Dufourmentel (7653)0.1 (0.0–0.2)73691.1 (0.8–1.4)…”

Section: Resultsmentioning

confidence: 99%

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Doll

Orlik

Maier

et al. 2019

Sci Rep

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Pilonidal sinus disease (PSD) is increasing globally. A recent meta-analysis and merged-data analysis showed that recurrence rates in PSD depend essentially on follow-up time and specific surgical procedures. However, the global distribution of surgical approaches and respective recurrence rates have never been studied in PSD. We aimed at studying the impact of geographic distribution of surgical approaches to treat PSD and subsequent geography-specific recurrence rates. We searched relevant databases as described previously. Recurrence rates were then associated with reported follow-up times and geographic origin. We simulated individual patients to enable analogy across data. Globally, recurrence rates range from 0.3% for Limberg/Dufourmentel approaches (95% CI 0.2–0.4) and flaps (95% CI 0.1–0.5) and up to 6.3% for incision (95% CI 3.2–9.3) at 12 months. Recurrence rates range from 0.3% for Karydakis/Bascom approaches (95% CI 0.0–0.8) up to 67.2% for incision (95% CI 7.5–100) in the USA, and 0.0% for primary asymmetric closure in Germany (95% CI 0.0–0.0). Our analysis shows that recurrence rates in PSD not only depend on therapeutic approaches and follow-up time but also on geography. Primary asymmetric closure and various flap techniques remain superior regardless of the geographical region. Some approaches have extraordinarily good outcomes in specific countries.

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Section: Resultsmentioning

confidence: 99%

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Doll

Orlik

Maier

et al. 2019

Sci Rep

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“…We reported in this study no reccurence rate and only a case of Wound breakdown. In Kose, et.al., [13] study which included a total of 802 patients who were operated on for pilonidal sinus in many techniques {primary closure, Limberg, and modified Limberg flap techniques} The reccurence rate was about {12%} in average to all techniques used in the study . Traditional techniques have aimed to remove the area of chronic inflammation as well as any potential remaining nidus of infection, with healing achieved via secondary intention or primary coverage with surrounding tissue flaps.…”

Section: Discussionmentioning

confidence: 99%

Five Layers Repair in Management of Pilonidal Sinus

Rizk

Kilany

Oraby

et al. 2020

Benha Journal of Applied Sciences

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Pilonidal disease is a common surgical problem primarily affecting young men between puberty and early thirties and is estimated to affect 26 per 100 000 individuals. surgery is still the primary method of treatment of the disease. Surgical management is usually simple, inexpensive, and is associated with a short hospital stay and rapid wound recovery. The aim of this study was to describe the effect of 5 layers repair technique in the management of pilonidal sinus as regard postoperative efficacy and results regarding pain,wound healing and recurrence. the study included 20 patients with a history of discharge from sacrococcygeal region that is clinically diagnosed as pilonidal sinus. Patients were treated by excision of the whole track till the pre sacral fascia and periosteum (Five Layers Repair) There mean age of patients was 31 years and 18 patients were males, 3 patients presented with discharge only , 6 of them with pain and 11 patient presented with both pain and discharge. Mean time to wound healing was 12 (±2), while Mean time to removal of stitches was 14( ±1) and 21 days was to return to work (±1), 19 patient came with complete healing and only 1 patient showed wound beakdown. Reccurence didn't happened to any patient after 6 month of surgery. Our findings indicated that 5 layers repair technique was superior to other techniques in terms of less operative time, less post-operative VAS of pain, no rate of recurrence presented with patients in our study.

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“…Additionally, an investigation on the practice parameters of PS management reported 9 individual studies that showed the recurrence rates were reduced by 60% in those treated with midline and off-midline closure methods after excision [121718]. Kose et al [19] reported that off-midline closure techniques are superior to primary midline closure technique regarding general complication, wound dehiscence, and recurrence rates. Based on our favorable results, we firmly believe that excision of PS with minimal tissue loss through an incision away from the midline is justified.…”

Section: Discussionmentioning

confidence: 99%

Inverse ‘D’ incision technique in treatment of pilonidal sinus disease; excision with minimal tissue loss, closure without tension and lateral location of the suture line

2019

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PurposeSurgical excision is the preferred treatment modality for sacrococcygeal pilonidal sinus (PS). Notably, the desirable features of an ideal surgical intervention are excision with minimal tissue loss, closure without tension, and a lateral suture line. The present study aimed to investigate early outcomes of surgical excision through the inverse D (ᗡ) incision based on tissue loss, wound tension, and suture line location.MethodsThis prospective study was comprised of 80 patients with PS in whom excision of PS was performed through the ‘ᗡ’ incision to minimize tissue loss with a tensionless primary surgical wound closure. The suture line was located laterally in all patients. Early and late postoperative complications, duration of hospital stay, return to work, and recurrence rates were investigated. The mean duration of the follow-up period was 36 months.ResultsSixty-three patients (78.8%) were male. PS in all patients was surgically removed by subcutaneous excision through a ‘ᗡ’ incision. Laterally placed surgical wounds were closed primarily with interrupted vertical mattress sutures. No general complications were encountered. Five patients (6.3%) experienced early postoperative surgical site complications. On average, the duration of hospital stay and return to work were 2.4 days and 3.8 days, respectively. Recurrence was seen in 1 case (1.3%) during the follow-up period. Satisfaction score was high in 83.8% of patients.ConclusionThe method of sinus excision using the ‘ᗡ’ incision with a primary suture facilitates excision with minimal tissue loss and closure without tension with an off-midline suture. It is both a simple and effective surgical technique for the treatment of sacrococcygeal PS.

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Comparative analysis of the same technique-the same surgeon approach in the surgical treatment of pilonidal sinus disease: a retrospective cohort study

Cited by 14 publications

References 23 publications

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Five Layers Repair in Management of Pilonidal Sinus

Inverse ‘D’ incision technique in treatment of pilonidal sinus disease; excision with minimal tissue loss, closure without tension and lateral location of the suture line

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