Excision and primary closure of sacrococcygeal pilonidal sinus using suction drain

Wani, Mohammad Saleem; Shah, Mudassar; Wani, Khurshid Alam; Malik, Ajaz Ahmad

doi:10.18203/2349-2902.isj20161158

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…For the ciNPT group, some patients were able to be discharged shortly after the initial pain assessment at 6 hours postoperative, which was a significantly shorter length of stay compared with patients receiving postoperative incisional care with gauze dressings where the length of hospital stay after the excision procedure ranged from 18 to 30 hours. This hospital length of stay for the gauze-treated group is similar to previously published studies 35,36 and consistent with findings from recent meta-analyses by Stauffer, 11 Kallis, 7 Wani, 37 and McCallum. 10 The healing time in the ciNPT group was also significantly shorter when compared with the control group.…”

Section: Discussionsupporting

confidence: 91%

Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy

Gabor¹,

Fávaro

Pedroso³

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Pilonidal cysts are a painful condition that primarily affect young adult men. In the literature, numerous operative techniques for resolving pilonidal cysts are described, with variable outcomes. The objective of this study was to compare primarily closed midline incisions managed with or without the use of closed incision negative pressure therapy after pilonidal cyst excision. Methods: Twenty-one patients underwent excision and midline primary closure. Postoperative care composed of closed incisional negative pressure therapy (study group; n = 10) or gauze dressings (control group; n = 11). In both groups, the sutures were partially removed on day 14 and completely removed on day 21. Compared outcomes included the duration of hospitalization, pain on the day of surgical procedure, and on postoperative day 7, and time-to-healing. Results: The median hospital stay was about 9 hours and 23 hours in the study and control groups, respectively ( P < 0.05). The median pain scores on the day of operation were 1.20/10 in the study group and 3.36/10 in the control group ( P < 0.05). On day 7, study group showed median pain score 0.9/10 and control group showed 2.63/10 ( P < 0.05). The mean healing time was 23.8 and 57.9 days in the ciNPT group and gauze group, respectively ( P < 0.05). Conclusion: These outcomes supported the incorporation of closed incision negative pressure therapy into our surgical treatment protocol for pilonidal cysts.

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Section: Discussionsupporting

confidence: 91%

Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy

Gabor¹,

Fávaro

Pedroso³

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

203

191

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We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure.

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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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Excision and primary closure of sacrococcygeal pilonidal sinus using suction drain

Cited by 3 publications

References 4 publications

Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy

Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

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

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