TO EVALUATE ADVANCED FLAP TECHNIQUE FOR PILONIDAL SINUS DISEASES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 8
Abstract
BACKGROUND Pilonidal sinus is an epithelial-lined tract, generally situated short distance behind anus. It contains hairs and unhealthy diseased granulation tissues. It is caused by penetration of hair through skin into subcutaneous tissues. When the disease is confirmed to the midline, one option is to excise the affected area and close it in an attempt to achieve primary healing. If this fails, a large wound occurs which heals by granulation. Even if primary healing is successful the patient remains at great risk of recurrent diseases, as there is now a midline scar deep within the natal cleft through which hairs may penetrate with greater ease than through undamaged skin. Since there is no single standard operation, poor results discourage surgeons, surgeons do not promptly take up this surgery. There is late presentation because of poor awareness and illiteracy in rural areas. Infection at presentation takes longer treatment and prolonged hospitalisation. In view of all these, we have taken this series of 40 cases of treatment of pilonidal sinus by advanced flap technique for study of morbidity and recurrences. The aim of this study is to evaluate advanced flap technique for Pilonidal sinus diseases. MATERIALS AND METHODS This is a case series study. Our present series comprises of 40 consecutive cases over a period of 3 years duration. Cases were divided into 3 categories- Category I, Category II and Category III. Sinus was excised by an encircling quadrangular incision. Incision was deepened from all sides till fascia and entire sinus excised. Haemostasis was achieved. Flap was raised as shown in diagram (Figure 1) and stitched after putting a closed suction drain (Figure 2). RESULTS There were 34 male patients and 6 were females. Mean age in Category 1 was 22 years, in Category 2 was 26 years and in Category 3 was 20 years. Post of drain removal was on 5th, 6th and 7th day respectively in Category 1, 2 and 3. Post-operative complication was wound infection requiring dressing up to 10 days in 10% cases. Wound infection requiring dressing for more than 10 days was in 17.5% cases. Recurrence was found in 7.5% cases. CONCLUSION Pilonidal sinus is a disease where a variety of surgical procedures have been prescribed. Not a single technique is fool proof. Search for ideal procedure is on. We at our hospital at SGT Medical College, Gurugram, are practicing advanced flap technique for a little over 3 years. Our results show that this technique is easy to practice, and results are reasonably good in terms of recurrence.
Authors and Affiliations
Kanwar Singh Goel, Sapna Goel
Keywords
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- EP ID EP410158
- DOI 10.14260/jemds/2018/221
- Views 92
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