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Evaluation of intradermal absorbable and mattress sutures to close pilonidal sinus wounds with Limberg flap: a prospective randomized comparative study

Annals of Surgical Treatment and Research 2018년 94권 2호 p.88 ~ 93
KMID : 0371420180940020088
 ( Cetin Kenan ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery

 ( Sikar Hasan Ediz ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery
 ( Kocaoglu Aytac Emre ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery
 ( Kundes Muhammet Fikri ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery
 ( Karahan Mehmet ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery
 ( Kaptanoglu Levent ) - Dr. Lutfi Kirdar Kartal Research and Education Hospital Department of General Surgery

Abstract

Purpose: We aimed to compare skin closure techniques, standard (intermittent mattress) and continuous subcuticular sutures, following Limberg flap procedure.

Methods: From July 2013 to July 2015, 92 patients with sacrococcygeal pilonidal disease were prospectively randomized into 2 groups consisting of 46 patients for both. Patients underwent sinus excision and closure with Limberg flap; continuous subcuticular suture was used in subcuticular group (SG) and intermittent mattress sutures were used in mattress group (MG) for skin closure. Characteristics of patients, features of pilonidal disease, macerations, infections, wound dehiscence, flap necrosis, operation time, time of drain removal, wound complications, early recurrences, and time till return to work were compared between the 2 groups.

Results: There was no statistical difference between groups per sex, age, body mass index, smoking, number of sinuses, depth of intergluteal sulcus, distance of incision to anus, volume of extracted tissue, number of hair follicles per cm2, recurrence, operation, and mean follow-up time. Two patients showed signs of wound complications (4.4%) in SG, whereas 8 cases (17.4%) showed signs in MG (P < 0.05). One patient in SG had surgical site infection and required antibiotics (2.2%), where as there were 6 cases treated in MG (13.0%) (P < 0.05). Removal of drain tube, and time till return to work rates are lower for SG than MG (P < 0.05).

Conclusion: In conclusion, surgical procedures which include Limberg flap method and subcuticular closure may reduce infection and maceration rates. Future studies are needed to achieve greater detailed evaluation.
KeyWords

Pilonidal sinus, Sutures, Surgical flaps
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