Sacrococcygeal pilonidal disease surgery optimization

Abstract

The aim — to improve the surgical treatment results of sacrococcygeal pilonidal cysts.Materials and methods. Surgical treatment of 451 patients with sacrococcygeal pilonidal cysts was performed. Depending on the treatment method, patients were divided into two groups: the main — 226 patients who underwent surgical treatment using the developed method of median resection with internal biodegradable sutures that did not require removal, and comparison — 225 patients who underwent surgical treatment in the traditional way using removable nodal sutures with cutaneous fixation. All patients were operated on an outpatient basis under local anesthesia.Results and discussion. The time of outpatient treatment and epithelialization of the wound was twice shorter in the study group than the comparison (7 vs 16 days, 13 vs 27 days, respectively). The recurrence rate was significantly lower (3.1 % versus 10.6 %). Suppurations of the postoperative wound were also recorded more frequently in the comparison group: 2 (0.9 %) and 9 (4 %), respectively.Conclusions. The use of the developed method for the surgical treatment of sacrococcygeal pilonidal cysts due to the economical resection of the skin flap with pathologically altered tissues, the use of sutures with internal fixation, which do not create external pressure on the skin of the wound edges preventing ischemia and microcirculation disturbance, significantly improves the results of surgical treatment of sacrococcygeal pilonidal cysts, decreases the suppuration frequency of the postoperative wound (to 0.1 %). decreases relapse (to 3.1 %) and has significant advantages over the traditional method. The healing period of the postoperative wound decreased to 13 days (in the comparison group‑ 27 days), the duration of outpatient treatment — to 7 days (versus 16 days with the traditional method).