Research Article
Volume 8 Issue 1 - 2021
Use of Primary Closure on Tension-Free Midline for Treatment of Sacrococcygeal Pilonidal Disease: Experience and Results
Santiago de la Fuente1, Jhimy Terceros2, Daniela Castillo3 and Luis Carlos Ferrari4*
12nd Year Resident General Surgery, Sanatoria Aconcagua and Santo Tomás Private City of Córdoba, Argentina
23rd Year Resident General Surgery, Sanatoria Aconcagua and Santo Tomás Private City of Córdoba, Argentina
34th Year Resident General Surgery, Sanatoria Aconcagua and Santo Tomás Private City of Córdoba, Argentina
4Head of the Aconcagua and Santo Tomás Private Sanatorium Coloproctology Section of the City of Córdoba, Argentina
*Corresponding Author: Luis Carlos Ferrari, Head of the Aconcagua and Santo Tomás Private Sanatorium Coloproctology Section of the City of Córdoba, Argentina.
Received: October 07, 2020; Published: December 10, 2020




Abstract

Background: Currently the surgical treatment for Sacrococcygeal pilonidal disease (SPD) is based on a wide resection of the lesion with or without its primary closure. Performing the latter over the primary midline suturing is simple and widely known, though with elevated dehiscence and relapsing infection. Primary closure far from the midline, as proposed by Karydakis or by the use of grafts like the Limberg technique, show better results. Although, when the primary closure is performed tension-free over the midline, results can be equivalent to those reached by these techniques, therefore it should be considered.

Aim: Prospectively assess the tension-free primary closure technique over the midline and their results in the treatment for SPD.

Design: Prospective observational study.

Method: 49 consecutive patients underwent SPD surgery between 01.10.2010 and 30.11.2019 by the same surgeon, where a tension-free primary closure was performed.

Results: 49 consecutive patients underwent surgery; mean age was 20,9 years old (between 14 and 37 years old) from which 69,38% (34 of 49) were men. Post-operative complications included, 1 patient showed bleeding (2, 04%); 16 patients partial opening of the primary closure (32,65%). Relapse occurred in 2 patients (4,08%) with 95,91% healing (47/49). Only 1 patient presented infection in the surgical wound (2,04%). Hospital stay was 1 day in all of the cases. Immediate post-operative intervention was not necessary. Healing time was 31,06 days (19 minimum/ 52 maximum). Pathological anatomy revealed non-malignant pilonidal cyst in all of the cases, with lesion-free resection in the margins. All patients expressed full conformity with the procedure.

Conclusion: The tension-free primary closure technique is a simple procedure, with brief hospital stay and with a low recurrence index or complications, reason why it should be considered when choosing a surgical technique in order to solve this pathology.

Keywords: Pilonidal Disease; Tension Free Closure

References

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Citation: Luis Carlos Ferrari.,et al. “Use of Primary Closure on Tension-Free Midline for Treatment of Sacrococcygeal Pilonidal Disease: Experience and Results”. EC Gastroenterology and Digestive System 8.1 (2021): 16-24.

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