Authors
Korablina S.S.1, 2
1 Stavropol State Medical University, Stavropol
2 City Clinical Hospital № 2, Stavropol
Abstract
Rationale. Pilonidal sinus is a common condition frequently encountered by surgeons and coloproctologists. Its prevalence is approximately 0.5–1.0% of the population. The majority of patients with pilonidal sinus undergo surgical intervention before the age of 30. Postoperative complications occur in 13–24% of patients, disease recurrence is observed in 6–30%, and pathological scarring develops in 13–17%.
Aim. To improve treatment outcomes for patients with pilonidal sinus complicated by single and multiple fistulas in the sacrococcygeal–gluteal region by developing new surgical techniques and refining approaches to patient care in the preoperative and postoperative periods.
Materials and Methods. This research paper presents the results of a clinical study and subsequent treatment of 159 patients suffering from a pilonidal sinus complicated by single and multiple fistulas. When choosing the treatment method, parameters such as the extent and severity of the inflammatory process, the topographic-anatomical features of the sacrococcygeal and gluteal region, the specifics of its blood supply, as well as the tendency to form pathological scars were taken into account. Based on this, surgical options and a complex of therapeutic measures aimed at improving the effectiveness of treatment for the observed patients have been proposed and implemented.
Results. This multifactorial and personalized approach contributed to more successful treatment outcomes compared to data from other studies: early postoperative complications occurred in 12 patients (7.5%), disease recurrence was observed in 5 patients (3.2%), and hypertrophic scars were recorded in 6 operated patients (3.7%). The average length of hospital stay was 9.7±0.34 days.
Conclusion. Analysis of data from the treatment of 159 patients with a pilonidal sinus complicated by fistulas in the sacrococcygeal and gluteal region (SCGR) showed that to achieve favorable short-term and long-term postoperative outcomes, the following is necessary: more thorough preoperative preparation; individualized selection of the surgical technique based on the location and number of fistulous tracts; consideration of the topographic-anatomical structure and blood supply characteristics of the sacrococcygeal and gluteal region, the predisposition to excessive scarring, the size of the postoperative wound, as well as rational postoperative management tailored to the individual characteristics of each patient.
Keywords: pilonidal sinus, microcirculation, sacrococcygeal and gluteal region, pathological scarring.
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