Sinus pilonidalis fisztuloszkópos kezelése gyermekekben

Összefoglaló. Bevezetés: A sinus pilonidalis nehezen kezelhető, sok szövődménnyel és recidívával járó betegség. A legtöbb műtéti eljárás többnapos kórházi kezelést, munkából vagy iskolából való hiányzást követel. Célkitűzés: Munkánk célja, hogy a PEPSiT- (pediatric endoscopic pilonidal sinus treatment) műtétek eredményességét vizsgálja. Módszer: Intézetünkben 2019–2020-ban PEPSiT-műtéten átesett, 18 év alatti betegeket válogattunk be a vizsgálatba. Kizártuk a cisztoszkóppal operált és kontrollra nem jelentkező betegeket. A szövődmények, recidívák számát, a kórházi tartózkodás hosszát, a sebgyógyulás és a hétköznapi aktivitáshoz való visszatérés idejét vizsgáltuk. Eredmények: Betegeink többsége fiú (24 fiú, 4 lány), átlagéletkoruk 15,6 év volt. 28 betegen 31 PEPSiT-beavatkozást végeztünk (3 re-PEPSiT), 6 recidíva, 1 sebgennyedés alakult ki. A betegek egy része egynapos ellátás keretében, míg a többség egy éjszaka bentfekvés után tért haza (1,74 nap ápolási idő). A hétköznapi aktivitáshoz 1,37 nap után tértek vissza, a gyógyulási idő 5,9 hét volt átlagosan. Megbeszélés: A PEPSiT-beavatkozás minimálisan invazív lehetőség, igen rövid kórházi tartózkodással. A betegek hamar térnek vissza a szokott aktivitásukhoz, a korábbi sipolyon kívül újabb műtéti seb nem alakul ki. A recidívaarány hasonló az egyéb technikákéhoz. Következtetés: A PEPSiT-beavatkozás jól alkalmazható, a recidívaarány csökkentése fontos. Orv Hetil. 2021; 162(43): 1740–1743. Summary. Introduction: The treatment of pilonidal disease is often challenging, due to frequent recurrences and adverse events. Most operative treatments require a lengthy hospital stay, and absence from school or work. Objective: We aimed towards assessing the effectivity of PEPSiT (pediatric endoscopic pilonidal sinus treatment). Method: In this study, we included patients subjected to PEPSiT from 2019 to 2020 between ages 0–18 years. Patients operated via cystoscope and patients who did not attend follow-up examinations were excluded. Adverse events, recurrences, length of hospital stay, wound healing time and return to everyday activity were assessed. Results: The majority of our patients were male (24 male, 4 female), the mean age was 15.6 years. 31 PEPSiT operations were recorded on 28 patients (3 were redo surgeries). 6 recurrences and 1 wound suppuration were documented. Some patients were treated within the confines of one-day surgery, while most of them stayed one night (mean length of stay was 1.74 days). Return to everyday activity was an average 1.37 days, and mean wound healing time was 5.9 weeks. Discussion: PEPSiT is a minimally invasive operative approach with a very short hospital stay. Patients return to everyday activity faster. New operative scarring does not happen apart from the preexisting fistula opening. Recurrence rate is similar to that of other treatment techniques. Conclusion: PEPSiT technique is applicable, however, reduction of the recurrence rate is important. Orv Hetil. 2021; 162(43): 1740–1743.

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Efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing in treating grade III/IV hemorrhoids: a retrospective study

BMC Surgery ◽

10.1186/s12893-021-01251-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qiuxiang Yu ◽

Congcong Zhi ◽

Lansi Jia ◽

Hui Li

Keyword(s):

Wound Healing ◽

Postoperative Complications ◽

Recurrence Rate ◽

Dentate Line ◽

Healing Time ◽

Post Operation ◽

Time Required ◽

Wound Healing Time ◽

Normal Work ◽

Grade Iii

Abstract Background Hemorrhoids are common. Hemorrhoidectomy should typically be offered to patients whose symptoms result from external hemorrhoids or combined internal and external hemorrhoids with prolapse (grades III/IV). However, none of the currently used surgical methods could be considered an ideal surgical option that is effective, safe, and painless. We hypothesized that a combination of Ruiyun procedure for hemorrhoids (RPH) and simplified Milligan–Morgan hemorrhoidectomy (sMMH) will increase the safety and effectiveness of surgical treatment hemorrhoids. This study aimed to evaluate the efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing (RPH + sMMH) to treat grade III/IV hemorrhoid. Methods Total 452 patients with hemorrhoids of grade III/IV were retrospectively reviewed in China-Japan Friendship Hospital, 244 cases were assigned to RPH + sMMH group, and 208 cases in MMH group. The primary efficacy outcome was rate of curative at 3 month after operation, and the recurrence rate within 12 months post operation. Secondary efficacy outcomes included wound healing time, time required to resume normal work, constipation symptom, quality of life, and pain post operation was also evaluated. The safety outcome included postoperative complications. Results There were no differences between the two groups in demographic characteristics. There was no statistically significant difference between the two groups in the curative rate. The recurrence rate after 12 months post operation in the RPH + sMMH (3.0%) was significantly lower than the sMMH group (7.8%) (P = 0.032). The wound healing time was significantly shorter in RPH + sMMH group than that in MMH group (P < 0.001). The time required to resume normal work in the RPH + sMMH group was significantly shorter than MMH group (P < 0.001). Compared with the MMH group, the RPH + sMMH therapy preserve better life quality and lower constipation symptom (all P < 0.05). Patients who underwent RPH + sMMH had significantly less postoperative pain than MMH therapy. The total rate of patients with postoperative complications in the RPH + sMMH group (8.6%) was significant lower than the MMH group (16.3%) (P = 0.012). Conclusion RPH + sMMH may more effective in treating patients with III/IV hemorrhoids, which indicated lower recurrence rate, lower postoperative complications and pain, shorter recovery and return to normal life.

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Results of surgical treatment of pilonidal sinus in 50 patients operated by the Bascom 2 method – prospective study

Polish Journal of Surgery ◽

10.5604/01.3001.0013.5050 ◽

2019 ◽

Vol 91 (5) ◽

pp. 1-5

Author(s):

Paweł Dutkiewicz ◽

Przemysław Ciesielski ◽

Małgorzata Kołodziejczak

Keyword(s):

Quality Of Life ◽

Wound Healing ◽

Pilonidal Sinus ◽

Surgical Care ◽

Wound Dehiscence ◽

Healing Time ◽

Physical And Mental Health ◽

The World ◽

Wound Healing Time

Introduction: Treatment of the pilonidal sinus, due to the various surgery method, remains the current topic of discussion during surgeon meetings around the world. The newest methods of treatment consist in the excision and simultaneous closure of the wound with the cleft lift techniques. One of such methods is the Bascom 2 technique widely used in the world and less popular in Poland. Aim of the study: To evaluate the results of treatment of pilonidal cysts using the Bascom 2 method performed by one operator. Material and method: 50 patients (40 men, 10 women), Avg. 30.6 years of age, All patients treated with the Bascom 2 method in one surgical ward by one operator (resident during specialization training) with the use of a uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalization time, pain, post-operative complications, wound healing time, patient's quality of life, and the percentage of recurrences after surgery. The follow-up period ranged from 12 to 52 months. Results: Average BMI 27.13 kg / m2. Avg. time of hospitalization 2.95 days. Postoperative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day of. 2.04 points (+/- 1.58 points); in the 30th day of the 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Postoperative complications occurred in 28.57% of patients (partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%). The average time of full healing was 2.94 weeks. The recurrence occurred in one patient (2.04%). Conclusions: Bascom 2 method is characterized by low recurrence rate and short wound healing time. It is a safe, effective and patient-accepted treatment method. Statistically significantly improves the patient's quality of life one year after surgery in terms of both physical and mental health.

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LASER ABLATION FOR PILONIDAL DISEASE

Koloproktologia ◽

10.33878/2073-7556-2020-19-2-91-103 ◽

2020 ◽

Vol 19 (2) ◽

pp. 91-103

Author(s):

D. A. Khubezov ◽

R. V. Lukanin ◽

A. R. Krotkov ◽

A. Y. Ogoreltsev ◽

P. V. Serebryansky ◽

...

Keyword(s):

Laser Ablation ◽

Postoperative Pain ◽

Hospital Stay ◽

Recurrence Rate ◽

Pilonidal Sinus ◽

Pilonidal Disease ◽

Main Group ◽

Cosmetic Result ◽

Control Group ◽

Primary Wound Closure

AIM: to evaluate short-term results of pilonidal disease treatment using different methods: the excision of pilonidal sinus and fistula with open wound healing, the primary closure of the wound and the laser ablation (2017-2019).PATIENTS AND METHODS: ninety patients with pilonidal disease without abscess were included in the comparative non-randomized study. The control group included 30 patients with excision and open wound healing. The first main group included 30 patients with the excision of pilonidal sinus and fistula with primary wound closure. The second main group included 30 patients with laser ablation of pilonidal sinus and fistula. The evaluation criteria included gender, age, BMI, number of previous procedures, operative time, hospital stay, postoperative pain intensity (VAS), cosmetic result (VAS), complication rate and recurrence rate.RESULTS: all three groups were homogeneous in gender, age, BMI. The control group showed no complications (р<0.0001) and no recurrence (р<0.0001) rate but had more intensive pain (mean 5.9 points; р<0.0001) and worse cosmetic result (mean 4.4 points; р<0.0001). The group with primary wound closure (1st main group) had the highest complication rate (23.4%; р=0.004) and recurrence rate (16.7%; р=0.02). The group with laser ablation had significantly shorter hospital stay (1.1 days; р<0.0001), good cosmetic result (mean 8.9 points; р<0.0001) and less postoperative pain (1.4 points; р<0.0001) with low recurrence rate (3.3%; p=0.32).CONCLUSION: the laser ablation of pilonidal sinus and fistula provides less postoperative pain intensity and low recurrence rate, better cosmetic result and short hospital stay. It can be used for outpatient treatment.

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Laying Open and Curettage under Local Anesthesia to Treat Pilonidal Sinus: Long-Term Follow-Up in 111 Consecutively Operated Patients

Clinics and Practice ◽

10.3390/clinpract11020028 ◽

2021 ◽

Vol 11 (2) ◽

pp. 193-199

Author(s):

Pankaj Garg ◽

Vipul D. Yagnik

Keyword(s):

Hospital Stay ◽

Local Anesthesia ◽

Pilonidal Sinus ◽

Pilonidal Disease ◽

Operating Time ◽

Healing Time ◽

Long Term Follow Up ◽

Normal Work

(1) Background: Several techniques for the treatment of pilonidal sinus disease (PSD) are in vogue, though none have emerged as the gold standard. Laying open (deroofing) and curettage under local anesthesia is one of the most straightforward procedures to treat PSD. In this study, the long-term follow-up in a large series was analyzed. (2) Methods: The laying open approach was performed for all types of consecutive PSD patients—simple, complicated, and abscess. The primary outcome parameter of the study was the healing rate. The secondary outcome parameters were operating time, hospital stay, time to resumption of normal work, and healing time. (3) Results: 111 (M/F–92/19, mean age-22.9 ± 5.7 years) consecutive patients were operated on and followed for 38 months (6–111 months). Of these, 24 had pilonidal abscesses, 87 had chronic pilonidal disease, while 22 had recurrent disease. Operating time and hospital stay were 24 ± 7 min and 66 ± 23 min, respectively. On average, patients could resume normal work in 3.6 ± 2.9 days and the healing time was 43.8 ± 7.4 days. Three patients were lost to follow-up. Complete resolution of the disease occurred in 104/108 (96.3%) patients, while 4 (3.7%) had a recurrence. One recurrence was due to a missed tract, while three recurrences presented after complete healing had occurred. Two patients with recurrence were operated on again with the same procedure, and both healed completely. Thus, the overall success rate of this procedure was 98.1% (106/108) with a recurrence rate after first surgery of 3.7% over a median follow-up of 38 months. (4) Conclusions: Pilonidal disease managed by laying open (deroofing) with curettage under local anesthesia is associated with a high cure rate. This procedure is effective in treating all kinds of pilonidal disease (simple, complicated, and abscess).

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Stump healing in below knee amputations using soft versus rigid dressing

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i2.23987 ◽

2018 ◽

Vol 5 (2) ◽

pp. 23-26

Author(s):

Rajendra Prasad Sah

Keyword(s):

Wound Healing ◽

Hospital Stay ◽

Healing Time ◽

Prospective Analysis ◽

Cross Sectional ◽

Knee Amputation ◽

Wound Healing Time

Introductions: Different techniques of postsurgical dressings are used after a below-knee amputation (BKA). This study compares the application of soft dressings versus rigid dressings on healing time and hospital stay after BKA. Methods: In this cross sectional prospective analysis of outcome of two types of post-operative dressings after BKA during January 2012 to January 2018 at Shree Bhawani Hospital Birgunj, Nepal. Wound healing time and hospitalisation were compared between soft and rigid dressings. Results: Out of 37 BKA, 20 received soft dressings with knee immobiliser and 17 rigid plaster dressings. Average age of patients in soft dressing group was 41 years (range 10-70) and in plaster dressing group 37.7 years (range 10-70). Two out of 20 (10%) with soft dressing and 13 out of 18 (76.47%) with the rigid dressing healed primarily, p <0.001. Patients treated with soft dressings stayed in the hospital on an average of 35.2 days (range 22-49 days) and rigid dressings 18.4 days (range12-31 days). Conclusions: The patients with rigid dressings after BKA had significantly more primary wound healings and shorter length of hospitalisation compared to soft dressing.

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Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽

10.1024/1023-9332.8.6.255 ◽

2002 ◽

Vol 8 (6) ◽

pp. 255-258 ◽

Cited By ~ 28

Author(s):

Perruchoud ◽

Vuilleumier ◽

Givel

Keyword(s):

Hospital Stay ◽

Pilonidal Sinus ◽

Primary Closure ◽

Average Length ◽

Length Of Hospital Stay ◽

Healing Time ◽

Incision And Drainage ◽

The Mean ◽

Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

JOURNAL OBGIN EMAS ◽

10.25077/aoj.1.2.47-55.2017 ◽

2019 ◽

Vol 1 (2) ◽

pp. 47-55

Author(s):

Syahredi Syaiful Adnani ◽

Hafni Bachtiar

Keyword(s):

Wound Healing ◽

Caesarean Section ◽

Amniotic Membrane ◽

Healing Time ◽

Cost Of Care ◽

Control Group ◽

P Value ◽

Control Groups ◽

And Control ◽

Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

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FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182605173445 ◽

2018 ◽

Vol 26 (5) ◽

pp. 342-345 ◽

Cited By ~ 5

Author(s):

Daniel Baumfeld ◽

Tiago Baumfeld ◽

Benjamim Macedo ◽

Roberto Zambelli ◽

Fernando Lopes ◽

...

Keyword(s):

Wound Healing ◽

Healing Time ◽

Diabetic Patients ◽

Distal Stump ◽

Vascular Intervention ◽

Laboratory Parameters ◽

Amputation Level ◽

Study Results ◽

Preoperative Antibiotics ◽

Wound Healing Time

ABSTRACT Objective: There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining the level of amputation and the wound healing time. Methods: One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study. Results: The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics. Conclusion: Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy. Level of Evidence III, Retrospective Study.

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A comparative study between fistulotomy and fistulectomy in management of low anal fistulae

International Surgery Journal ◽

10.18203/2349-2902.isj20174882 ◽

2017 ◽

Vol 4 (11) ◽

pp. 3665 ◽

Cited By ~ 2

Author(s):

Ganesan R. ◽

Karunakaran K. ◽

Heber Anandan

Keyword(s):

Wound Healing ◽

Operating Time ◽

Healing Time ◽

Human Beings ◽

Fistula In Ano ◽

Post Surgery ◽

Group I ◽

Hospital Stays ◽

Group Ii ◽

Wound Healing Time

Background: Fistula in ano is a silent menace in human beings, the treatment is a challenging one even for experienced surgeons, fistula in ano forms a good majority of treatable benign lesions of rectum and anal canal. Aim was to study the efficacy of fistulotomy and fistulectomy in the treatment of low anal fistulae.Methods: A randomized control study was conducted to compare fistulotomy with fistulectomy in patients with low anal fistulae.Results: The operating time in fistulotomy group was 12.13minutes±2.11minutes and in fistulectomy group was 22.23±3.36minutes. The post-surgery hospital stays in Group I was 1.80±0.66days and in Group II was 2.60±0.563 days. The wound healing time in Group I was 24.20±2.95 days which was considerably less when compared to patients in Group II where it was 31.50±4.34 days.Conclusions: Fistulotomy has a slight edge over fistulectomy in the treatment of low anal fistulas since it has shorter operating time, less post-operative pain, less complications, quicker wound healing time, less incontinence and a comparable recurrence rate.

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Assessment of Frailty In Elderly Patients Attending A Multidisciplinary Wound Care Center: A Cohort Study.

10.21203/rs.3.rs-764391/v1 ◽

2021 ◽

Author(s):

Mariona Espaulella-Ferrer ◽

Joan Espaulella-Panicot ◽

Rosa Noell-Boix ◽

Marta Casals-Zorita ◽

Marta Ferrer-Sola ◽

...

Keyword(s):

Wound Healing ◽

Elderly Patients ◽

Healing Rate ◽

Wound Care ◽

Frailty Index ◽

Healing Time ◽

Venous Ulcers ◽

Healing Wounds ◽

Wound Healing Time ◽

The Relationship

Abstract Background: The incidence of frailty and chronic wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods: The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centers (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at six months or upon wound healing. Wounds were followed up every two weeks. To analyze the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyze the evolution of the frailty index during follow-up.Results: A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at six months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p=0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p=0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p=0.637). Wound healing rate is statically significantly higher in non-frail patients (3,26% wound reduction/day, P25-P75 0.8-8.8%/day) in comparison with frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day; p=0.044). Conclusion: Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

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