Five-year Follow-up and Recurrence Rates Following Surgery for Acute and Chronic Pilonidal Disease: A Survey of 421 Cases.

Autor:	Fahrni GT; Department of Surgery, Hospital Bülach, Zürich, Switzerland., Vuille-Dit-Bille RN; Department of Surgery, Hospital Bülach, Zürich, Switzerland and Department of Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland., Leu S; University of Zurich, Zürich, Switzerland., Meuli M; Department of Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland., Staerkle RF; Department of Surgery, Clinic for Visceral and Thoracic Surgery, Hospital Winterthur, Switzerland., Fink L; Mathematic faculty, Cantonal School of Wil, St. Gallen, Switzerland., Dinçler S; Department of Surgery, Hospital Bülach, Zürich, Switzerland., Muff BS; Department of Surgery, Hospital Bülach, Zürich, Switzerland.
Jazyk:	angličtina
Zdroj:	Wounds : a compendium of clinical research and practice [Wounds] 2016 Jan; Vol. 28 (1), pp. 20-6.
Abstrakt:	Objective: The aim of the present study was to investigate the outcomes of different treatment options for acute and chronic pilonidal disease in a single large cohort of patients. Materials and Methods: Four hundred and twenty-one consecutive patients (171 with chronic disease and 250 with acute abscess formation) who underwent surgery between 2003 and 2012 were included in the present study. Primary outcomes included symptomatic recurrence, time to wound healing, and time off from work. The median follow-up was 5.3 years. Results: In patients with acute abscess formation, the relapse rate was significantly higher (P = 0.0001) if they were treated with abscess excision (38.9%) compared with a wide local excision (13.3%). Time to relapse was significantly longer (P = 0.0205) in patients treated with wide local excision (median 7 vs 3 months), whereas time to wound healing and the days off from work were similar among groups. In chronic disease, the relapse rate was similar in patients treated with wide local excision followed by secondary wound healing (11.3%) when compared with patients treated with limited excision (27.6%) or wide excision with primary wound closure (26.8%). The time to wound healing was shortest in patients with primary wound closure following wide local excision, and the time off from work was not significantly different between groups. Conclusion: Wide local excision with secondary wound healing seems to be the favorable operation method for acute and chronic pilonidal disease.
Databáze:	MEDLINE
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