| Objective: With the deepening of people’s understanding of the pilonidal sinus disease,there are a variety of treatment methods,but because of the characteristics of prolonged course of disease and easy recurrence after treatment,there is still no ideal treatment for this disease.In this paper,the clinical effects of vacuum sealing drainage(VSD)in the treatment of pilonidal sinus disease were compared with simple resection and suture and skin flap transplantation,and the advantages and disadvantages of negative pressure closed drainage were analyzed and summarized in order to provide reference for the selection of surgical treatment of pilonidal sinus disease.Methods: In strict accordance with the selection and inclusion criteria,a total of 77 patients with pilonidal sinus treated in our hospital from January 2019 to December 2021 were divided into VSD group,skin flap group and suture group.Their hospitalized medical records and postoperative follow-up information were collected.SPSS 26.0statistical software was used for statistical calculation to analyze the clinical efficacy of VSD in the treatment of pilonidal sinus disease.Results: 23 patients were treated with excision of the focus of the pilonidal hair sinus combined with VSD,including 17 males and 6 females,the youngest age was 17 years old,the oldest age was 39 years old,the average age was 23.22 ±4.76 years old,the course of disease was 8.17 ±2.17 months,BMI was 27.65 ±3.10kg/m2.13 patients(56.5%)complained of local acute symptoms of sacrococcyx(redness and swelling,increased skin temperature,pain or empyema).14 cases(60.9%)reported their hairy physique and 10 cases(43.5%)had a history of hairy sinus surgery.A total of 21 patients in the treatment group were treated with Limberg flap transplantation,including 16 males and 5 females,aged from 14 to 32 years old,the average age was 22.90 ±5.01 years old,the course of disease was 8.90 ±5.16 months,the BMI was 30.25 ±5.35kg/m2,15 patients(71.4%)had hairy constitution,and 6 patients(28.6%)had been treated with pilose sinus surgery.There were 33 cases in the pilonidal sinus focus resection and suture group,including 25 males and 8 females,aged from 13 to 60 years old,the average age was 25.32 ±10.05 years old,BMI was 28.92 ±4.75kg/m2,and there were 19 patients with hairy constitution(57.6%).There were 44 patients in VSD group and skin flap group,and there was no significant difference in clinical data.There were significant differences in operation time,wound size,dressing change times,hospital stay and postoperative pain score between VSD group and skin flap group(P < 0.05),but there was no significant difference in wound healing time(P > 0.05).In terms of operation time,the operation time of VSD group and skin flap group was 46.30 ±11.99 min and 120.48 ±26.74 min respectively,which was significantly better than that of flap transplantation.The skin flap needs free skin flap,so the wound surface of the skin flap is larger than that of the VSD group,and the frequency of dressing change is more than that of the VSD group.The patients in the two groups were evaluated with VAS pain score on the 1st,3rd and 7th day after operation,with a score of 0 to a full score of 10 indicating gradual aggravation of pain.In this study,on the first day after operation,the scores of VSD group and skin flap group were 5.13 ±1.22,5.81 ±1.50 respectively,P > 0.05.There was no significant difference in pain score between the two groups on the first day after operation.The pain scores on the 3rd and 7th day after operation in VSD group were 4.04 ±1.07,2.48 ±0.95 respectively,which were significantly lower than those in skin flap group(P < 0.05).According to the long-term wound complications of patients with pilose sinus,all patients were followed up for at least 12 months,and the disease and complications were effectively communicated and collected during the follow-up period.the long-term local sensory abnormalities of the sacrum were effectively relieved during the follow-up period.The postoperative complications in VSD group and skin flap group were 5 cases(21.7%)and 11 cases(52.4%)respectively,with significant difference(P < 0.05).Because of the grouping bias,the patients with mild clinical symptoms,single sinus and chronic stage were included in the resection and suture group,which was quite different from the patients in the VSD group and the skin flap group,so there was no statistical analysis,but only the intraoperative and postoperative results of the VSD group and the suture group were simply compared.Overall,compared with the suture group,the VSD group had shorter operation time,less times of dressing change and lower complication rate,but the wound was larger,the hospital stay was longer,and the average healing time was 26.83 d and 31.63 d,respectively.During the follow-up period,1 patient(4.3%)relapsed in the VSD group and 5 patients(15.2%)in the suture group.Conclusion: 1.In the surgical treatment of pilonidal sinus disease,VSD has the advantages of low difficulty of operation,short operation time,less postoperative pain,less times of dressing change,low complication rate and recurrence rate.2.VSD can be used in all inflammatory stages of pilonidal sinus disease,and it can also be used as a remedy for the failure of other surgical methods,which can be popularized in clinic. |
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