- Comparative characteristics of pilonidal sinus surgical treatment methods in children
Comparative characteristics of pilonidal sinus surgical treatment methods in children
Paediatric surgery.Ukraine.2021.4(73):72-76; doi 10.15574/PS.2021.73.72
Bodnar O. B.1, Randiuk R. Yu.1, Bodnar B. M.1, Vatamanesku L. I.1, Sokolnyk S. O.1, Khoma M. V.2
1Department of pediatric surgery and otolaryngology of Bucovinian state medical university, Chernivtsy, Ukraine
2Municipal Medical Establishment «Children’s clinical city hospital», Chernivtsi, Ukraine
For citation: Bodnar OB, Randiuk RYu, Bodnar BM, Vatamanesku LI et al. (2021). Comparative characteristics of pilonidal sinus surgical treatment methods in children. Paediatric Surgery.Ukraine. 4(73):72-76; doi 10.15574/PS.2021.73.72.
Article received: Aug 06, 2021. Accepted for publication: Dec 08, 2021.
Pilonidal sinus (PS) is a common pathology of the coccygeal area, which occurs with a frequency of 26 per 100000 people. Operative methods of treatment of PS are accompanied by a high frequency of complications and recurrences. Finding ways to treat PS in children, which will help to reduce frequency of complications and the duration of postoperative wound healing remains relevant.
Purpose – to make a comparative analysis of the pilonidal sinus treatment methods in children: skin-fascial plastics, suturing to the bottom of the wound and suturing the wound tightly.
Materials and methods. An analysis of 90 cases of PS in children operated at the City Children’s Clinical Hospital was provided. Methods of skin and fascial plastics in our own modification, sinus removal with sewing to the fascia and primer closure were compared. The duration of surgery, time of postoperative wounds healing, intensity of pain in the postoperative period, duration of hospitalization and the frequency of complications were analyzed.
Results. The rate of pain intensity was on 60% lower on the first day and on 70% on the second and third days in cases of using skin-fascial plastics in comparison with the methods of sewing to the fascia and primer closure. Healing time was the shortest in cases of using skin-fascial plastics. The frequency of postoperative complications was by three times lower in operations with the method of skin-fascial plastics in comparison to other methods.
Conclusions. Skin-fascial plastics method reduces the intensity of pain more than 60% in comparison to other methods and reduces wound healing time more than 26% and 65% in comparison of the groups of sewing to the fascia and primer closure, respectively. The technique of removing of PS with skinfascial plastics in children usage reduces the number of complications by three times.
The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
Key words: pilonidal cyst, skin-fascial plastics, children.
REFERENCES
1. Farrell D, Murphy S. (2011). Negative pressure wound therapy for recurrent pilonidal disease: a review of the literature. J Wound Ostomy Continence Nurs. 38: 373-378. https://doi.org/10.1097/WON.0b013e31821e5117; PMid:21606863
2. Iesalnieks I, Ommer A, Petersen S et al. (2016). German national guideline on the management of pilonidal disease. Langenbecks Arch. Surg. 401 (5): 599-609. https://doi.org/10.1007/s00423-016-1463-7; PMid:27311698
3. Duman K, Gırgın M, Harlak A. (2017). Prevalence of sacrococcygeal pilonidal disease in Turkey. Asian Journal of Surgery. 40: 434-437. https://doi.org/10.1016/j.asjsur.2016.04.001; PMid:27188235
4. McCallum IJ, King PM, Bruce J. (2008). Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 336: 868-871. https://doi.org/10.1136/bmj.39517.808160.BE; PMid:18390914 PMCid:PMC2323096
5. Meneiro P, Mori L, Gasloli G. (2014). Endoscopic pilonidal sinus treatment (E. P. Si.T.). Techniques in Coloproctology. 18 (4): 389-392. https://doi.org/10.1007/s10151-013-1016-9; PMid:23681300
6. Hussain F, Bramham B, Parveen S, Chakaravarty B. (2018). Pilonidal sinus: Surgical outcome of lay open versus primary closure technique. Journal of Dental and Medical Sciences. 17 (2): 1-7.
7. Pini Prato A, Mazzola C, Mattioli G et al. (2018). Preliminary report on endoscopic pilonidal sinus treatment in children: results of a multicentric series. Pediatric Surgery International. 34 (6): 687-692. https://doi.org/10.1007/s00383-018-4262-0; PMid:29675752
8. Yuksel ME. (2017). Pilonidal sinus disease can be treated with crystallized phenol using a simple three-step technique. Acta Dermatovenerol APA. 26 (1): 15-17. https://doi.org/10.15570/actaapa.2017.4; PMid:28352930
9. Gecim IE, Goktug UU, Celasin H. (2017, Apr). Endoscopic pilonidal sinus treatment combined with crystalized phenol application may preven trecurrence. Dis Colon Rectum. 60 (4): 405-407. https://doi.org/10.1097/DCR.0000000000000778; PMid:28267008