Negative pressure wound therapy following excision of pilonidal sinus disease: A retrospective review

Abstract Background Pilonidal sinus disease (PSD) is a common condition that can have a detrimental impact on patient quality of life. Definitive surgical management for PSD is challenging and remains a contentious issue. Primary closure is associated with a high recurrence rate, while healing by secondary intention comes with slow healing and burdensome wound care. Negative pressure wound therapy (NPWT) is widely used to accelerate healing. Aim To evaluate outcomes in patients with PSD treated by a standardised technique of complete surgical excision followed by the application of NPWT. Method A retrospective observational cohort study of all patients with PSD managed by complete surgical excision followed by application of NPWT was performed over a 5-year period. Results 41 patients underwent excision of PSD with application of NPWT during the observation period. All patients’ wounds healed successfully with NPWT. Only one patient (2.4%) developed recurrent PSD and required further surgery. Discussion The ideal surgery for PSD should have a low recurrence rate. Our results demonstrate that our technique of complete surgical excision followed by application of NPWT meets all these criteria. To our knowledge, this study contains the largest number of patients with PSD managed by excision and NPWT in the literature.

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Assessing safety of negative-pressure wound therapy over pedicled muscle flaps: A retrospective review of gastrocnemius muscle flap

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2015.11.010 ◽

2016 ◽

Vol 69 (4) ◽

pp. 519-523 ◽

Cited By ~ 4

Author(s):

Samuel Lance ◽

Lindsey Harrison ◽

Hakan Orbay ◽

David Boudreault ◽

Gavin Pereira ◽

...

Keyword(s):

Negative Pressure ◽

Retrospective Review ◽

Gastrocnemius Muscle ◽

Negative Pressure Wound Therapy ◽

Muscle Flap ◽

Wound Therapy ◽

Muscle Flaps

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Combination of Side-Swing Flap With Negative-Pressure Wound Therapy Is Superior to Open Excision or Flap Alone in Children With Pilonidal Sinus—But at What Cost?

Frontiers in Pediatrics ◽

10.3389/fped.2021.595684 ◽

2021 ◽

Vol 9 ◽

Author(s):

Deborah Dorth ◽

Ingo Königs ◽

Julia Elrod ◽

Tarik Ghadban ◽

Konrad Reinshagen ◽

...

Keyword(s):

Recurrence Rate ◽

Pilonidal Sinus ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Healing Time ◽

Hybrid Technique ◽

Patient Counseling ◽

Wound Therapy ◽

The Right ◽

Open Excision

Background: Pilonidal sinus (PS) disease frequently occurs in adolescents and young adults, and in many cases involves wide excision or local flaps as treatment. These treatments are associated with a significant recurrence rate, a long healing time, and thus absence from school or work. The hybrid technique, which is a combination of side-swing plasty with negative-pressure wound therapy (NPWT) may improve these outcomes. The aim of the study was to compare the latter with other current methods.Methods: Children presenting with a pilonidal sinus to two referral centers for pediatric surgery from January 2017 till June 2019 and subsequent (1) slide-swing plasty, (2) open excision, or (3) slide-swing plasty in combination with NPWT were included in this retrospective study. Type of therapy, number of interventions, duration of hospitalization, complications, and recurrence rate were recorded. In addition, data was retrieved from the national diagnosis-related group for inpatient statistics, for all patients who underwent surgery for pilonidal sinus in 2015 and 2016.Results: In total, 85 children were included, with a mean age of 15 years and a near equal gender distribution (53% female). The minimum follow-up was 1 year. In 56% open resection was performed, while 18% underwent a slide-swing plasty and 26% a slide-swing plasty in combination with NPWT. While the hybrid technique was superior regarding recurrence rate in comparison to open excision (24 vs. 5%, p = 0.047), it had significantly longer hospital stay [17.41 (15.63) vs. 3.65 (1.68) days, p < 0.001] and number of interventions [4.14 (4.07) vs. 1.04 (0.29), p < 0.001].Conclusions: Management of PS disease using slide-swing plasty in combination with NPWT is an effective treatment and is associated with low recurrence rate and minimal morbidity. However, this type of treatment is accompanied by an elongated hospitalization time and more frequent interventions. A diligent case by case evaluation and thorough patient counseling is thus necessary when choosing the right technique for the treatment of PS disease.

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Loxoscelism and Negative Pressure Wound Therapy (Vacuum-Assisted Closure): A Clinical Case Series

The American Surgeon ◽

10.1177/000313480907501121 ◽

2009 ◽

Vol 75 (11) ◽

pp. 1128-1131

Author(s):

S. Lindsey Wong ◽

Andrew J. Defranzo ◽

Michael J. Morykwas ◽

Louis C. Argenta

Keyword(s):

Negative Pressure ◽

Retrospective Review ◽

Clinical Case ◽

Negative Pressure Wound Therapy ◽

Chronic Wounds ◽

Case Series ◽

Vacuum Assisted Closure ◽

Wound Therapy ◽

Significant Challenge ◽

Life Threatening

Brown recluse spider (Loxosceles sp) bites continue to be a significant challenge to manage clinically. Sequelae from these lesions range from chronic necrotic ulcers that persist for months to an acute life-threatening course of sepsis. Negative pressure wound therapy using vacuum-assisted closure (VAC) has been described for use in both acute and chronic wounds. We present a novel application for the use of this therapy in a retrospective review of eight clinical cases treated with the VAC.

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