Rhomboid Flap vs. Keystone Perforator Island Flap (KPIF) in the Treatment of Pilonidal Sinus Disease: Comparison of Short-Term Results

Marius D. Roatis, A. Georgescu
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引用次数: 1

Abstract

Background: Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. Although many techniques have been described, there is no consensus on the treatment of pilonidal sinus disease (PSD). Materials and Methods: This study included 30 patients with PSD who were treated between May 2014 and September 2017. All cases underwent excision and flap reconstruction. The operative time, postoperative complications, the length of hospital stay, painless sitting and walking time, patient satisfaction and recurrence were evaluated prospectively. Results: The results of this prospective, randomized and comparative study are based on experience of a single surgical centre. All patients were followed up 18 months after discharge from the hospital. There is a difference in surgery durations (minutes) between the two groups (33.86 ± 2.89 min. in “keystone” flap vs. 41.26 ± 4.19 in the “rhombic” flap group) (p = 0.001). There were no significant differences in the length of hospital stay, painless sitting and walking time or patient satisfaction. The total complication rate was 66.6% after rhomboid flap compared with 6.6% after keystone flap. There was no flap necrosis. Conclusions: Both of these methods have shown to be successful in treatment of PSD. The KPIF is associated with the advantages of very simple design, abundant blood supply from the perforator vessels and lower rate of complication.
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菱形皮瓣与楔石穿支岛状皮瓣治疗毛毛窦疾病的近期疗效比较
背景:毛鞘病是一种主要影响年轻人的骶尾骨区慢性炎症性疾病。发病率为每10万人26例。虽然许多技术已经描述,没有共识的治疗毛毛窦疾病(PSD)。材料与方法:本研究纳入了2014年5月至2017年9月期间接受治疗的30例PSD患者。所有病例均行手术切除及皮瓣重建。对手术时间、术后并发症、住院时间、无痛坐行时间、患者满意度及复发率进行前瞻性评价。结果:这项前瞻性,随机和比较研究的结果是基于单一手术中心的经验。所有患者出院后随访18个月。两组手术时间(分钟)差异(楔型皮瓣33.86±2.89分钟vs菱形皮瓣41.26±4.19分钟)(p = 0.001)。在住院时间、无痛静坐和行走时间或患者满意度方面没有显著差异。菱形瓣术后总并发症发生率为66.6%,楔状瓣术后总并发症发生率为6.6%。无皮瓣坏死。结论:两种方法均可成功治疗PSD。KPIF具有设计简单、穿支血管供血充足、并发症发生率低等优点。
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