Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.
Department of Colorectal Surgery, Royal Derby Hospital, Derby Teaching Hospitals NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UK.
Tech Coloproctol. 2018 Oct;22(10):779-784. doi: 10.1007/s10151-018-1864-4. Epub 2018 Nov 9.
Pilonidal sinus disease (PSD) is a common, chronic inflammatory condition involving hair follicles within the natal cleft. It mainly affects young males and creates a significant health, social and economic burden. Traditional surgery is often radical resulting in pain, wound complications, long recovery times and poor cosmesis. The aim of our study was to evaluate fibrin glue as a primary treatment for PSD.
Fibrin glue procedures for a single surgeon at our institution were identified from operative coding databases and the logbook from January 2011 to January 2016. Patients had curettage of the sinus with fibrin glue obliteration. Recurrence data was collected retrospectively.
One hundred and forty-six patients were identified; (115 (79%) males, mean age 30 (range 16-78 years). One hundred and forty-four (99%) were discharged the same day. Four (2.7%) were treated conservatively for wound discharge. Median operating time was 9 (range 4-28) min. There were 40 (27%) recurrences after one glue application. Median time to recurrence was 4 (range 0.25-36) months. Twenty-four (60%) of the recurrences had repeat glue treatment with 4 (16.6%) recurrences. After 2 rounds of treatment with glue alone, 126 out of 130 (96.9%) patients had healed.
Fibrin glue application following curettage of the sinus is a quick and effective procedure for first and second line treatment of PSD.
藏毛窦疾病(PSD)是一种常见的慢性炎症性疾病,涉及会阴部的毛囊。它主要影响年轻男性,给健康、社会和经济带来重大负担。传统手术往往是根治性的,会导致疼痛、伤口并发症、恢复时间长和美容效果差。我们的研究目的是评估纤维蛋白胶作为 PSD 的主要治疗方法。
从 2011 年 1 月至 2016 年 1 月,我们从手术编码数据库和日志中确定了一位外科医生的纤维蛋白胶手术。患者接受窦道刮除术和纤维蛋白胶填塞。回顾性收集复发数据。
共确定了 146 名患者;115 名(79%)男性,平均年龄 30 岁(范围 16-78 岁)。144 名(99%)患者当天出院。4 名(2.7%)因伤口引流接受保守治疗。手术时间中位数为 9 分钟(范围 4-28 分钟)。一次胶应用后有 40 例(27%)复发。复发的中位时间为 4 个月(范围 0.25-36 个月)。24 例(60%)的复发患者再次接受纤维蛋白胶治疗,其中 4 例(16.6%)复发。单独使用纤维蛋白胶治疗 2 次后,130 例患者中的 126 例(96.9%)治愈。
窦道刮除术后应用纤维蛋白胶是治疗 PSD 的一线和二线治疗的快速有效方法。