scholarly journals Comparative study between excision with lay open and excision with primary closure in treatment of pilonidal sinus

2019 ◽  
Vol 6 (4) ◽  
pp. 1242
Author(s):  
B. N. Anandaravi ◽  
Aswath Viswanathan
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Open Group ◽  
Limberg Flap ◽  
Surgical Methods ◽  
Considerable Morbidity ◽  
Closure Method

Background: Pilonidal sinus is a common anorectal condition affecting young adults with various etiological factors. Various surgical methods have been described, but treatment failure and recurrence are frequent, causing considerable morbidity. This study was undertaken to study the different surgical methods in treatment of pilonidal sinus.Methods: This study was done between January 2017 and June 2018. 20 cases underwent excision with open healing and 10 cases underwent excision with primary closure. The surgeries for primary closure included Limberg flap, Karydakis technique and Z plasty. Patients were analyzed with respect to post operative complications, duration of hospital stay, duration of getting back to work and duration of wound healing.Results: Spectrum of clinical presentation included pain, discharge, sinus and swelling. No recurrences were observed in the present study. Wound infection occurred in only three cases. Duration of wound healing was found to be an average of 51.6 days in Excision with open healing method and 14.2 days in excision with primary closure method. The average length of hospital stay in excision and lay open group was 4.35 days and 5.4 days in the excision and primary closure group. The average duration to return to work was 34 days in excision and lay open group, while it was 8 days in excision and primary closure group.Conclusions: Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus.

scholarly journals SURGICAL TREATMENT OF CHRONIC PILONIDAL SINUS

2019 ◽  
Vol 141 (3-4) ◽  
pp. 63-67
Keyword(s):  
Wound Healing ◽  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Limberg Flap ◽  
Secondary Intention ◽  
One Year ◽  
Flap Closure

Chronic pilonidal sinus is an acquired skin disease resulting from chronic inflammation of an affected skin area. It creates a cyst with epithelized subcutaneous channels. The disease mostly affects younger men with elevated BMI and sedentary lifestyle being the main risk factors. The aim of this study was to compare wound healing times, seroma, wound infection and wound dehiscence frequency, average length of hospital stay and recurrence rate in patients undergoing first-time operation for chronic pilonidal sinus at the Surgery clinic of University hospital Mostar from June 2015 to June 2017, with recurrence rate monitoring for one one year after the operative procedure. The patients were divided into three groups by the type of operating procedure: excision with primary closure (23.0%), excision with healing by secondary intention (55.2%) and excision with Limberg flap closure (21.8%). Most of the patients included in this study had elevated BMI (72.4%). Patients who were operated using primary closure and Limberg flap closure had on average shorter wound healing times than patients operated with excision and secondary intention healing. Seroma frequency was highest in patients operated using primary closure (70.6%) and lowest in patients operated using Limberg flap closure (29.4%). Average length of hospital stay was 6.4 days (min 3, max 13; SD 1.919). There were no statistically significant differences in hospital stay between different types of operating procedures used. Patients operated using Limberg flap closure had two (10.5%) cases of recurrence in the one year period after the operation. There were seven (35.0%) recurrences of the disease in patients operated using primary closure and six (12.5%) recurrences in patients operated using healing with secondary intention. The difference in the number of recurrences between patients operated using primary closure, healing by secondary intention and Limberg flap closure was borderline statistically significant. We find that Limberg flap closure reduces postoperative complications and wound healing time which improves postoperative recovery.

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

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
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.

scholarly journals Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence

2012 ◽  
Vol 97 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Akin Onder ◽  
Sadullah Girgin ◽  
Murat Kapan ◽  
Mehmet Toker ◽  
Zulfu Arikanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Disease Risk ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Faculty Department ◽  
Closure Method

Abstract The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P  =  0.039). Regarding recurrence, family tendency (P  =  0.011), sinus number (P  =  0.005), cavity diameter (P  =  0.002), and primary closure (P  =  0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.

COMPARISON OF QUALITY OF LIFE AND EFFECTIVENESS OF LIMBERG FLAP VERSUS LAY OPEN IN SACROCOCCYGEAL PILONIDAL SINUS TREATMENT: A PROSPECTIVE CLINICAL STUDY.

2021 ◽  
pp. 74-75
Author(s):  
Robindera Kour ◽  
Gurpreet Kour ◽  
K.K. Gupta
Keyword(s):  
Quality Of Life ◽  
Wound Healing ◽  
Local Excision ◽  
Pilonidal Sinus ◽  
Wide Local Excision ◽  
Primary Closure ◽  
Open Group ◽  
Limberg Flap ◽  
Complete Wound Healing

Aim:to compare the quality of life and effectiveness of limberg ap vs lay open in sacrococcygeal pilonidal sinus treatment. Methods: This randomized prospective study was carried out in the Government Hospital Sarwal, Jammu, India among 30 patients. Patients were randomized into two groups; group Awith 15 patients was undergone wide local excision followed by limberg ap primary closure while the other group B with 15 patients was undergone wide local excision followed by Lay open ap (healing by Post operatively assessment of healing time and quality of life at 4 and 8 weeks was done.). Results: Mean age of the subject of the limberg ap group and lay open group was 22.42 years and 22.38 years respectively. 90% of the patient's (27 patients) of the present study were males. In limberg ap group 53.3% patient achieved complete wound healing around 20-30 days while in lay open group 60.0% patient achieved complete wound healing around 51-60 days post operatively Conclusions:Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus

scholarly journals Modified Limberg flap versus modified Karydakis flap in pilonidal sinus disease: single surgeon experience

2019 ◽  
Vol 6 (9) ◽  
pp. 3069
Author(s):  
Umit Turan
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Complication Rates ◽  
Sinus Disease ◽  
Surgeon Experience ◽  
Modified Limberg Flap

Background: The aim of this study was to analyze and compare the results of the modified Limberg flap (MLF) and modified Karydakis flap (MKF) techniques which were performed for the treatment of pilonidal sinus disease (PSD).Methods: The patients who were operated for PSD by the same surgeon between November 2010 and July 2013 in Konya Seydisehir Hospital were retrospectively analyzed. A total of 106 patients were evaluated in this study regarding age, gender, operation time, length of hospital stay, and postoperative complications.Results: There were 14 female and 92 male patients (MLF; 5/52 and MKF; 9/40). MLF was performed in 57 (53.8%) patients and MKF was performed in 49 (46.2%) patients. Length of Hospital stay and drain removal time were less in MKF group but it was not significantly different between two groups (p>0.05). Operation time was shorter in MKF group than MLF group (p<0.05). The complication rates of the MLF and MKF groups were 10.5% and 12.2% respectively. The recurrence was seen in 1 patient in MLF group and 2 in MKF group.Conclusions: MKF has shorter operation time than MLF, however both techniques have a similar complication and recurrence rate. In conclusion MLF and MKF procedures can be safely used as a surgical treatment of PSD.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

scholarly journals Detection of influenza virus in rectal swabs of patients admitted in hospital for febrile illnesses in Thailand

2021 ◽  
Vol 9 ◽  
pp. 205031212198963
Author(s):  
Artit Sangkakam ◽  
Pasin Hemachudha ◽  
Abhinbhen W Saraya ◽  
Benjamard Thaweethee-Sukjai ◽  
Thaniwan Cheun-Arom ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Gastrointestinal Tract ◽  
Hospital Stay ◽  
Rectal Swab ◽  
Average Length ◽  
Gastrointestinal Symptoms ◽  
Virus Detection ◽  
Length Of Hospital Stay ◽  
Nasopharyngeal Swab ◽  
Influenza Virus Detection

Introduction: Influenza virus favours the respiratory tract as its primary site of host entry and replication, and it is transmitted mainly via respiratory secretions. Nasopharyngeal swab is the gold standard specimen type for influenza detection, but several studies have also suggested that the virus replicates in the human gastrointestinal tract. Methods: A retrospective study was conducted on all patients positive for influenza virus and initially recruited as part of the PREDICT project from 2017 to 2018. The objectives of the study were to investigate whether rectal swab could aid in improving influenza detection, and if there was any correlation between gastrointestinal disturbances and severity of infection, using length of hospital stay as an indicator of severity. Results: Of the 51 influenza-positive patients, 12 had detectable influenza virus in their rectal swab. Among these 12 rectal swab positive patients, influenza virus was not detected in the nasopharyngeal swab of three of them. Gastrointestinal symptoms were observed for 28.2% patients with a negative rectal swab negative and 25.0% patients with a positive rectal swab. Average length of hospital stay was 4.2 days for rectal swab positive group and 3.7 days for rectal swab negative group. This difference was not statistically significant (p = 0.288). Conclusions: There is no correlation between influenza virus detection in rectal swab and gastrointestinal disturbances or disease severity, and there is currently insufficient evidence to support replicative ability in the gastrointestinal tract.

Compare outcome of simple excision with primary closure vs rhomboid excision with limberg flap for pilonidal sinus

2021 ◽  
pp. 2920-2922
Author(s):  
M. Kaleem ◽  
F. Mubarik ◽  
M. U. Afzal ◽  
A. Zahid ◽  
W. I. Andrabi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
P Value ◽  
Limberg Flap ◽  
Simple Excision ◽  
Group A ◽  
Group B ◽  
Rhomboid Excision

Background: Sacrococcygeal pilonidal sinus is a common condition usually affecting young-to-middle-aged men. For managing sacrococcygeal pilonidal illness, a variety of lateralizing surgical flap procedures based on this principle have been published, including the Karydakis flap, Limberg flap, modified Limberg flap, Z-plasty, and Y-V advancement flap. Aim: To compare the outcome of simple excision with primary closure versus rhomboid excision with limberg flap for sacrococcygeal pilonidal sinus. Methodology: Randomized control study conducted in Surgery Department, Ghurki Trust Hospital, Lahore. 90 patients fulfilling the inclusion criteria were selected from wards and were randomly divided in two equal groups. In group A, patients underwent rhomboid excision with limberg flap. In group B, patients underwent simple excision with primary closure. The operation was performed under spinal anesthesia. After surgery, patients were evaluated every 24 hours if they are able to move on their own then they were discharged and hospital stay was noted. Then after 10 days, patients will be called in OPD for assessment of wound healing. If wound did heal and patient complained of pain (VAS>4) and cannot sit and have fever (temp>100oF) Results: The average age in group A was 44.37±15.42 years while that in group B was 45.24±14.50 years. In group A there were 23(51.1%) males and 22 (48.9%) females whereas in group B there were 25(55.6%) males and 20(44.4%) females. There was difference significant in the mean stay in hospital in both groups (p-value=0.002). Conclusion: The conclusion of the study, that primary sacrococcygeal pilonidal sinus disease and rhomboid excision with Limberg's flap is an effective treatment. Keywords: Simple Excision with Primary Closure, Rhomboid Excision, Limberg Flap, Sacrococcygeal Pilonidal Sinus

scholarly journals Critical Pathway and Hospital-Hospital Cooperation in Acute Stroke Reduction of the Length of Hospital Stay

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 251-255 ◽  
Author(s):  
Y. Hashimoto ◽  
T. Terasaki ◽  
T. Yonehara ◽  
M. Tokunaga ◽  
T. Hirano ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Stay ◽  
Acute Stroke ◽  
Neurological Disease ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Stroke Patients ◽  
Critical Pathway ◽  
Hospital Days ◽  
Other Neurological Disease

Stroke patients tend to stay longer in one hospital compared to patients with other neurological disease. After the introduction of 3 types of critical pathway dedicated for various severity of acute ischemic stroke in 1995, the average length of in-hospital days declined from 30.0 days (1993) to 15.3 days (1998), ie 49% reduction. This reduction was achieved by the use of critical pathway and the hospital-hospital cooperation.

scholarly journals Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

2019 ◽  
Vol 101 (1) ◽  
pp. 21-29 ◽  
Author(s):  
M Arnous ◽  
H Elgendy ◽  
W Thabet ◽  
SH Emile ◽  
SA Elbaz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Primary Closure ◽  
Randomised Clinical Trial ◽  
Limberg Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Group I ◽  
Group Ii

BackgroundAlthough several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.MethodsThis was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes.ResultsSixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence.ConclusionsThe Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

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