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Year 2018 Vol. 26 No 5
GENERAL & SPECIAL SURGERY
L.A. LICHMAN, S.E. KATORKIN, P.S. ANDREEV, O.E. DAVYDOVA, A.P. MIHAYLICHENKO
PILONIDAL SINUS: NEW APPROACH TO OPERATIVE TREATMENT
Samara State Medical University, Samara,
The Russian Federation
Objective. To improve the results of treatment in patients with the pilonidal sinus by developing and implementing a new method of surgical treatment.
Methods. By random sampling, patients (n=111) were divided into two groups. In the control group (n = 68), a conventional technique was used – the excision of the pilonidal sinus with sutures according to Moshkovich. In the main group (n=43) the developed operative technique – the excision of the pilonidal sinus with wound closure by the method of marsupialization with a continuous suture – was used.
Results. The average duration of immediate surgical treatment: the excision of the pilonidal sinus with closure of the wound by the method of marsupialization with a continuous suture made up 21.9±4.3 min., the excision of the pilonidal sinus with Moshkovich sutures – 30.9±5.4 min., statistically significant differences were not found. With ultrasound of soft tissues in the area of the postoperative wound, the infiltration zone in the main group was 5.3±1.0 mm, in patients of the control group 10.7±0.92 mm, statistically significant differences were found, p <0.05.
In the postoperative period, the patients of the main group showed less intensity of the pain syndrome. Severity of pain in the area of a postoperative wound by VAS for the first day in the main group was 3.6±0.4 and in the control group 5.6±0.6; on the third day, 2.07±0.35 and 4.7±0.6, respectively; on the fifth day 0.96±0.33 and 3.9±0.63; on the tenth day – 0±0.005 and 0.45 ± 0.33. Statistical processing of the obtained results revealed statistically significant differences for the first (p<0.05), the third (p <0.05), the fifth (p < 0.05) day. A statistically significant (χ2=14.8, p<0.05) decrease in the number of early postoperative complications (suppuration of the postoperative wound, inconsistency of cutaneous sutures) in the main group to 4.6% was obtained.
Conclusions. The use of a continuous suture combined with marsupialization to close the wound defect after excision of the pilonidal sinus is an effective method of surgical treatment and allows improving the results of treatment in patients with this pathology.
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443079, The Russian Federation,
Samara, Karl Marks Ave., 164 B,
Clinic of Samara
State Medical University,
Department and Clinic of Hospital Surgery,
Tel. office: +7 927 900 88 58,
Leonid A. Lichman
Lichman Leonid A., Surgeon, Surgical Unit, Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Katorkin Sergey E., PhD, Associate Professor, Head of the Department and Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Andreev Pavel S., PhD, Assistant of the Department of Hospital Surgery, Coloproctologist, Coloproctology Unit, the Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Davydova Olga E., Coloproctologist, Coloproctology Unit, the Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Mikhailichenko Alena P., Ultrasound Diagnostic Doctor, Samara State Medical University, Samara, Russian Federation.