Muzi's Tension Free Primary Closure of Pilonidal Sinus Disease: Long-Term Results on 450 Patients

Muzi, M Gallinella; Mosconi, Claudia; Colella, Marco; Cianfarani, Agnese; Mascagni, Pietro; Shalaby, Mostafa; Sileri, Pierpaolo

doi:10.1016/s0016-5085(17)34034-9

Cited by 2 publications

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“…20 Recently, the Muzi tension-free procedure was described to have low recurrence rate (0.4%), short operation time, minimal postoperative pain, early recovery and high patient satisfaction. 21 An alternative to Limberg flap is the rotational gluteal flap which relies on the same surgical principles, yet avoids the geometric rhomboid shape of Limberg flap, thus attains better cosmetic outcome. 22 It was postulated that SPND is correlated with male sex hormones, therefore, the disease mainly afflicts young and middle-age males in the second and third decades of life.…”

Section: Discussionmentioning

confidence: 99%

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Arnous

Elgendy

Thabet

et al. 2019

annals

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Background Although several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND. Methods This was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes. Results Sixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence. Conclusions The Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

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Section: Discussionmentioning

confidence: 99%

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Arnous

Elgendy

Thabet

et al. 2019

annals

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“…at riskRR in % (95% CI)Nr. at riskPrimary open (1243)0 (0.0–0.0)12032.5* (1.2–3.8)441*4.5* (2.5–6.6)267*NANA 35, 56, 70, 72, 80, 91, 94– 96, 99, 100, 120, 610– 613 Primary median closure (5583)3.3 (2.8–3.8)41847.6 (6.7–8.5)193910.1* (8.8–11.4)786*12.2 (10.3–14.2)382 35, 56, 91, 94– 96, 99, 100, 129, 144, 146, 161, 162, 165– 168, 171, 179, 182, 186, 197, 205, 209, 214, 215, 218– 222, 610– 621 Primary asymmetric closure (1099)0.0* (0.0–0.0)1099*0.0* (0.0–0.0)1096*0.1* (0.0–0.2)1022*3.6* (2.4–4.8)937* 100, 129, 256, 260, 622 Karydakis/Bascom (109)3.7 (0.0–7.4)109NANANANANANA 16, 622 Limberg/Dufourmentel (944)0.0* (0.0–0.0)944*0.3* (0.0–0.7)891*0.3 (0.0–0.7)618NANA 56, 100, 165, 182, 205, 328, 334, 336…”

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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Muzi's Tension Free Primary Closure of Pilonidal Sinus Disease: Long-Term Results on 450 Patients

Cited by 2 publications

References 0 publications

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

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

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