| ObjectiveTo investigate the clinical effect of modified Limberg flap transfer plasty combined with vacuum sealing drainage in the treatment of the sacrococcygeal Pilonidal sinus disease.MethodsThe author reviewed and analyzed 39 cases of sacrococcygeal Pilonidal sinus patients in the first affiliated hospital of soochow university from January 2014 to October 2019,They were divided into a treatment group and a control group depending on the surgical method,In the treatment group,Treatment group:there were 25 cases,including 21 males and 4 females,aged from 17 to 41 years old,with an average age of 24.28±6.48 years old and an average course of 12.52±3.72 months.The operation was performed with sacrococcygeal pilonidal sinus resection,modified Limberg flap transfer plasty and negative pressure closure drainage.VAC negative pressure drainage material was removed 1 week after surgery,and stitches were removed 2 weeks after surgery.Control group:there were 14 cases,including 13 males and 1 female,aged from 17 to 41 years old,with an average age of 24.71±6.38 years old,and an average course of disease of 13.07±3.97 months.The first operation was performed with sacrococcygeal pilonidal sinus resection and negative pressure closure drainage,and the second operation one week after the operation was performed with gluteal fissure midline closure and negative pressure closure drainage.VAC negative pressure drainage material was removed 1 week after the second operation,and the stitches were removed 2 weeks after the operation.Operation time,extubation time,hospital stay,return to work time,postoperative recurrence rate,postoperative bleeding rate,flap necrosis rate,wound infection rate,wound rupture rate,VAS pain score,vancouver scar score,cosmetic satisfaction score,and hospitalization cost were compared between the two groups.T test and Fisher's exact probability method were used to compare the difference of efficacy between the two groups.ResultsThe operation time,hospitalization time and return to work time of the treatment group were all shorter than those of the control group(t value wa---2.283?-3.756?-3.758,P value<0.05 or<0.01),and there was no significant difference in extubation time between the two groups(t value was 1.385,P value were both>0.05).The wound infection rate of the treatment group was lower than that of the control group(P<0.05),and there was no significant difference in postoperative recurrence rate,postoperative bleeding rate,flap necrosis rate,and wound rupture rate between the two groups(all P values were>0.05).VAS pain score lower than contrast treatment group patients after the first operation of VAS pain score(t value is-2.255,P values<0.05),the treatment group patients the VAS pain score and the control group of patients after the second operation of VAS pain score did not see obvious difference(t value is 0.865,P>0.05),two groups of vancouver scar rating of no obvious difference(t value is-0.502,P>0.05).The score of cosmetic satisfaction in the treatment group was lower than that in the control group(t=-2.577,P<0.05),and the hospitalization cost in the treatment group was lower than that in the control group(t=-2.327,P<0.05).ConclusionsThe modified Limberg flap has flexible flap design,clear anatomical level,good blood supply,large flap area,no damage to the main blood vessels,muscles and nerves,and the flap area is directly closed without free skin transplantation.The modified Limberg flap transfer plasty combined with vacuum sealing drainage for the treatment of the sacrococcygeal pilonidal sinus has the advantages of raising the intergluteal fissure,reducing the accumulation of sweat and hair,low incidence of postoperative complications,low recurrence rate,high patient satisfaction,short hospital stay,short return to work,and low hospital expenses,which is worthy of clinical application. |
PDF Full Text Request