Patient Satisfaction After the Cleft-Lift Procedure

Immerman, Steven C.

doi:10.7759/cureus.17686

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…It is in our view preferable to wide local excision and primary midline closures, which are still employed in many centres despite the adverse literature about the technique. In the medium term it has comparable results to other flap techniques including the Karydakis and Limberg, with low levels of morbidity and good cosmesis [22].…”

Section: Discussionmentioning

confidence: 92%

Cleft closure (the Bascom cleft lift) for 714 patients—treatment of choice for complex and recurrent pilonidal disease (a cohort study)

et al. 2023

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AimPilonidal disease is a benign condition that affects mainly the young. In existing literature, there is no consensus for best treatment, with multiple operative techniques described, some complex, resulting in a high proportion of failure and/or morbidity. The cleft closure (or cleft lift) described by Bascom and Bascom (Arch Surg, 137, 2002, 1146−50), by comparison, is a simple operation, resulting in healing in the majority and good cosmesis.MethodThis is a single surgeon series, with the aim of evaluating outcomes for consecutive patients who underwent cleft closure surgery at two centres (St Mark's Hospital, London, and Queen Alexandra Hospital, Portsmouth) between 1995 and 2021 for either extensive, complex or recurrent pilonidal disease. Primary study outcomes that were measured included rate of primary healing, time to complete healing and rate of recurrence.ResultsSome 714 patients had a cleft closure of whom 656 had documented follow‐up. Primary healing occurred in 60.7% (n = 398) rising to 88.5% by 12 weeks (n = 562) and 91.8% by 16 weeks. The remaining patients healed over the following weeks with only 19 wounds failing to heal completely (3%), requiring further surgery to achieve healing. After complete healing 5.3% of patients developed recurrent disease at a median of 12 months.ConclusionCleft closure is an effective operation for pilonidal disease. Overall, 97% of patients healed without further surgery. A 3% failure rate and 5.3% recurrence rate were observed. This technique could be considered as an alternative procedure to complex flaps or midline excision, in extensive, recurrent and unhealed pilonidal disease.

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Section: Discussionmentioning

confidence: 92%

Cleft closure (the Bascom cleft lift) for 714 patients—treatment of choice for complex and recurrent pilonidal disease (a cohort study)

et al. 2023

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“…A retrospective study in 2022 with a median follow-up time of ~8 years after Bascom surgery showed that the 10-year cumulative recurrence rate was only 27%, and the technique was safe enough for most patients 66 . A recent survey on postoperative satisfaction found that 98.8% (494/500) of patients felt “very satisfied” or “satisfied” with the outcome after surgery 67 .…”

Section: Discussionmentioning

confidence: 99%

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

Zhang

Wang

2023

International Journal of Surgery

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Background: A pilonidal sinus (PS) is an acquired disease resulting from recurrent infections and chronic inflammation. A PS involving the sacrococcyx is referred to as a sacrococcygeal PS (SPS). An SPS is a rare chronic infectious disease for which surgery is a good choice. The incidence of SPS has gradually increased worldwide in recent years. However, surgeons have not reached a consensus on the preferred surgical approach for SPS. The authors performed a systematic review and meta-analysis to analyze differences in the efficacy of different surgical approaches for the treatment of SPS. Methods: A systematic search was conducted in the PubMed database covering the period from 1 January 2003, to 28 February 2023. The primary outcome parameters were recurrence and infection. Finally, statistical analysis (meta-analysis) was carried out using RevMan 5.4.1 software. In addition, we systematically reviewed the latest progress in the surgical treatment of SPS over the past 20 years, especially as reported in the past 3 years. Results: Twenty-seven articles, 54 studies, and 3612 participants were included in this meta-analysis. The recurrence rate following the midline closure (MC) technique was much higher than that of other techniques. Among the techniques analyzed, the differences between MC and Limberg flap (LF), and between MC and marsupialization were statistically significant [P=0.0002, risk ratio (RR)=6.15, 95% CI 2.40, 15.80; P=0.01, RR=12.70, 95% CI 1.70, 95.06]. The recurrence rate of open healing was higher than that of the Karydakis flap (KF) technique, and the difference was statistically significant (P=0.02, RR=6.04, 95% CI 1.37, 26.55). Most of the results comparing MC with other techniques suggested that the former had a higher infection rate, and the difference between MC and LF was statistically significant (P=0.0005, RR=4.14, 95% CI 1.86, 9.23). Comparison between KF and LF, modified LF and KF showed that the differences were not statistically significant in terms of recurrence and infection (P≥0.05). Conclusions: There are various surgical treatment options for SPS, including incision and drainage, excision of diseased tissue with primary closure and secondary healing, and minimally invasive surgery. It is still not possible to determine which surgical technique should be considered the gold standard for treatment, as even the results of different researchers using the same operation method are conflicting. But what is certain is that the midline closure technique has a much higher incidence of postoperative recurrence and infection than other techniques. Therefore, the anorectal surgeon should formulate the most suitable individualized plan for the patient based on a comprehensive evaluation of the patient’s wishes, appearance of the SPS, and the professional ability of the surgeon.

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Patient Satisfaction After the Cleft-Lift Procedure

Abstract: ConclusionA correctly performed cleft lift operation provides a solution that is very well accepted by patients, specifically in regard to recovery time, appearance, appropriateness, and overall satisfaction.

Cited by 2 publications

References 9 publications

Cleft closure (the Bascom cleft lift) for 714 patients—treatment of choice for complex and recurrent pilonidal disease (a cohort study)

Cleft closure (the Bascom cleft lift) for 714 patients—treatment of choice for complex and recurrent pilonidal disease (a cohort study)

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

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