Introduction:Pilonidal sinus is a common infectious process which occurs in buttocks and sacral area which involves a wide range of symptoms that are different from an asymptomatic sinus abscess to acute and chronic sinus track. Basically non-surgical treatment for this disease is not recommended. In this study, we have been compared two methods of primary repair and rotation flap in terms of factors such as duration of hospitalization, recurrence, infection etc.Methods:80 patients with chronic pilonidal sinus were randomly divided into two groups and underwent surgery. Diabetic and obese patients with underlying diseases and patients with acute pilonidal abscess or prior surgery were excluded. The patients’ hospital stay, duration of postoperative pain, itching and hematoma, were investigated.Results:In this study, patients’ sex and mean age were examined in terms of frequency of complications of hematoma, wound infection, recurrence, itching, and duration of hospitalization and the presence of seroma, there is no significant difference between the two methods of primary surgical repair and rotation flap (P>0.05) But in terms of the opening of the surgical wound, in primary surgical method, 5 patients (12.5%), wound dehiscence were reported, in rotation flap, any case of wound dehiscence were reported. There is significant difference between wound dehiscence in patients with chronic pilonidal sinus and two methods of surgery. (P=0.02). The mean duration of pain relief was 15.2±3.35 days in the primary surgical repair method and rotation flap was 7±2.3 days. According to the test there is significant difference between mean duration of pain relief and two surgical methods. (P=0.001). The mean duration of sutures was 15.3±2.3 days in the primary repair method and in rotational flap was 12±3.6 days. There is significant difference between the mean duration of sutures and two surgical methods (P=0.001)Conclusion:Considering these results, rotational flap is the preferred method due to fewer complications, lower recurrence after surgery and faster healing time of surgical wounds and as a result, the effective force’s early return to economic cycle. Finally, we can say that each surgeon according to the type and size of the sinuses and occupational status and social class, personality and individuality of the patient can select the appropriate method of surgery.
Introduction:Burning is the second most common cause of home injuries in Iran that is often the cause of conflicts between children and young adults. Burning can lead to early and late complications that scar and contracture are the most common. Burn waste treatment is done by two methods: excision and then skin graft after the formation of granulation tissue; and excision and graft simultaneously that in this study, these two methods are compared.Methods:This was performed as a quasi-experimental analysis and retrospective study on all patients who were hospitalized for burn scar. All patients who have associated with weak eningimmune diseases such as diabetes, acquired immunodeficiency or congenital, taking steroids and patients undergoing chemotherapy etc. are excluded. The method of grafting in patients is primary graft procedure that was compared with patients who are treated using secondary graft. Data collected through review of patients’ hospital and clinic chart.Results:The mean burn percentage in the primary repair group was 14.4% and in the delayed repair group was 16.6%, respectively. The incidence of hematoma in both groups was zero. Skin necrosis and graft rejection and infection in the primary repair group was in 3.7% of patients and in the delayed repair group was in 1.2% of cases (P=0.5)Conclusion:Based on the findings of this study, no difference was observed between the two methods of excision and primary graft with delayed graft in the incidence of graft rejection. Due to the shorter treatment of primary graft and patient satisfaction and also according to the findings of this study excision and primary graft method seems appropriate method for treating old waste burning.
Background: Pilonidal sinus disease is a common infectious process that occurs on the natal cleft and sacrococcygeal part. The treatment of pilonidal sinus disease remains challenging and despite the existence of many non-surgical and surgical methods, there is no consensus for the best treatment for this disease. Objective: The goal of this study is to investigate the outcomes of pilonidal sinus surgery by three methods of semi-open, primary repair, and elliptical rotational flap. Methodology This prospective randomized study was conducted on patients suffering from primary pilonidal sinus. The patients were randomly assigned to one of the three groups based on surgical technique, were followed according to a checklist within the first, second and fourth weeks, as well as third and sixth months after surgery. Follow up was done in terms of recurrence, surgical complications, post-operative pain, and duration of hospitalization. Results: One hundred forty-six patients completed the study, including 21 women and 125 men. The mean age of patients was 26.56 ± 5 years. There was only one case of recurrence and the rate of post-operative haematoma and infection were not significant between groups, while the rate of itching problem was significantly different (P-value = .001). The highest degree of itching, haematoma and infection were in the semi-open, rotational flap and primary repair group, respectively. The mean duration of pain relief and time of hospitalization were 25.73 ± 11.36 hours and 4.41 ± 1.56 days, respectively, which were significantly different between groups. The longest mean duration of pain relief and hospitalization were in primary repair and semi-open group, respectively. Conclusions: Elliptical rotational flap is preferred to the other two methods due to less pain, lower recurrence rate after surgery and early return of patients to the economic cycle.
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