Treatment of Patients with Uncomplicated Sacrcoccygeal Sinus

Abstract

Introduction. Despite the progress made in the treatment of patients with sacrococcygeal sinus, the number of complications in the early postoperative period does not decrease below 23%; 12% of operated patients experience relapses of the disease, 14% of patients develop rough scars and discomfort in the area of surgical intervention.The aim of the study was to improve clinical outcomes of patients with uncomplicated sacrococcygeal sinus.Materials and methods. The study included 152 patients who underwent surgical interventions: 79 (52,0%) - with sacrococcygeal sinus in the stage without clinical manifestations and 73 (48,0%) - in remission. In addition to the standard laboratory and instrumental examination, the following parameters were studied: predisposition to the development of excessive scarring, the importance of acute-phase inflammation proteins in predicting the development of pathological scars. A group of patients prone to excessive scarring was identified, measures were taken to prevent its development. The authors proposed options for surgical treatment of sacrococcygeal sinus using an intradermal suture. Results. When comparing long-term clinical outcomes of conventional treatment of patients with uncomplicated sacrococcygeal sinus and an integrated approach, there was revealed a decrease in the development of gross cicatricial deformity in the area of ​​surgical intervention by 2,7 times, discomfort in the sacrococcygeal region by 3,7 times, the number of the disease relapses by 2,4 times.Conclusion. To predict the development of pathological scarring after surgery, it is necessary to study the dynamics of changes in the concentrations of acute-phase inflammation proteins in the peripheral blood of patients. To improve clinical outcomes in patients tending to excessive scar formation, it is necessary to include anti-scar therapy in the complex of postoperative measures. An integrated approach can significantly improve clinical outcomes of patients with sacrococcygeal sinus.