BackgroundPilonidal sinus (PS) is a common disease of the sacrococcygeal-natal region. There are many treatment options, but there is still no consensus on the ideal treatment. We compared the results of our PS patients who were treated with primary midline closure (PMC), Limberg flap repair (LFR), and Karydakis flap (KF).Material/MethodsThe data for 924 PS patients from 2013 to 2017 were retrospectively examined. Demographic data, surgical procedures, schedules, and recurrence rates were examined.ResultsThe mean age was 28.4 years (14–77 years), 82.5% were male (n=762), and 17.5% were female (n=162). PMC was performed on 53.7% (n=496) of the patients, 32.5% (n=300) received LFR, and 13.9% (n=128) underwent KF. PMC was the first choice among females but LFR was the first choice in recurrent patients. The recurrence rate was 10.8% in the PMC group, 8% in the LFR group, and 3.1% in the KF group. In Short Form Survey-36 (SF-36) scores, the best cosmetic outcomes were observed in cases of PMC (p<0.05). Overall, wound dehiscence (WD) was observed in 7.5%, surgical site infection (SSI) in 2.4%, and seroma in 8.5% of all patients. The KF group had the lowest complication rates (p<0.01).ConclusionsAccording to the results of this study, the reason for preferring PMC among women is cosmetic concerns. PMC still remains important for treatment, but it should be noted that the recurrence rates due to inadequate excision are mostly observed in cases of PMC. Considering their low recurrence rates, LFR or KF should be considered first. When low recurrence rates, patient comfort, and cosmetic results are evaluated together, KF in particular emerges as a method preferred by physicians and patients.
The aim of this study was to explore the success rates of Bakri balloon placement in patients with placenta previa and uterine atony. In addition, we compared bilateral internal iliac artery ligation (B-IIAL) and Bakri balloon placement in terms of their ability to inhibit haemorrhage in postpartum placenta previa patients. The hospital reports filed annually from 2010 to 2015 were reviewed. In total, 54 patients were evaluated: 42 patients with placenta previa and uterine atony were treated with Bakri balloons, and 12 placenta previa patients with postpartum haemorrhage underwent B-IIAL when medical treatment failed. The results showed that the success rates of Bakri balloon placement rate in placenta previa and uterine atony patients were 71.4% and 89.2%, respectively. The comparative analysis of placenta previa patients treated via Bakri balloon placement and B-IIAL showed that the requirements for packed red blood cell and fresh frozen plasma, pre-and postpartum haemoglobin levels, pre-and post-partum platelet counts, and hospitalization times differed significantly between the two groups (all p < 0.05). Bakri balloon tamponade could be considered an effective treatment for placenta previa and uterine atony. The technique is minimally invasive and can serve as a second-line treatment for patients with postpartum haemorrhage when medical procedures fail.
Background: Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful for women and treatment strategies vary. However, there is a lack of knowledge about the outcome of surgical excision of CSS during caesarean section (CS). The study aims to determine the rate of recurrence and risk factors of recurrence for surgically removed CSS. Method: This is a retrospective cohort study that used STROBE guidelines. Pfannenstiel incisions of 145 patients were evaluated. Patients were divided into two groups: recurred (group 1, n = 19) and non-recurred group (group 2, n = 126). The groups were compared. Results: The rate of recurrence of CSS was 13% in the total cohort (19/145), one of the main outcomes of the study. While emergency CS was performed for 12 patients in group 1 (63%), CS was carried out in 25 patients in group 2 (20%); this difference was significant ( P = 0.001). Before surgery, white blood cell and neutrophil counts were significantly higher in group 1 ( P = 0.014 and P = 0.023, respectively). There were 11 dark-skinned women (26%; Fitzpatrick type 4) in group 1 and 31 (74%) in group 2. This difference was statistically significant ( P = 0.031). As the other main outcome, emergency CS could be accepted as a risk factor for recurrence in the multivariate regression analysis ( P = 0.060; odds ratio = 5.07; 95% confidence interval = 0.93–17.51). Conclusion: The rate of recurrence of surgically removed previous CSS at CS is promising without adjunct therapy. Emergency CS was found to be a risk factor for recurrence. Lay Summary Background Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful and are generally itchy and painful for women. Treatment strategies vary. However, there is a lack of knowledge about the outcome of only surgical excision of CSS scars during caesarean section (CS). The issue being explored There are few data in the literature for CSS in the lower abdomen. These scars can be removed during the second or third CS, but the results are not known exactly. How was the work conducted? In our clinic, 145 patients with CSS were given a CS and their scars were removed at the same time. While most of these scars were reported as hypertrophic by pathological examination, some were reported as keloid. At the earliest, one year after surgery, the rate of recurrence was found to be 13%. What we learned from the study Asymptomatic patients who are planning another pregnancy and do not want to receive any other radiotherapy or steroid injection therapy can wait to remove their CSS at the next CS, especially elective CS with or without adjunct therapy. Emergency CS was found to be a risk factor for the recurrence of these scars.
Aims: In recent years, very early pregnancies and very advanced pregnancies have increased. In our study, we aimed to compare these groups in terms of maternal and fetal risks. Materials and Methods: This study retrospectively were compared the perinatal outcomes of women of reproductive age in 80 early adolescent pregnant (16 years and younger) and 67 older pregnant women (45 years and older) followed in Siirt Training and Research Hospital between 2017 and 2021 in Siirt Training and Research Hospital (Siirt, Turkey). In cases gravida, parity, hemogram, biochemistry, urine, week of birth, fetal weight, gender, APGAR 1-5. min, mode of delivery (vaginal delivery/ cesarean section), miscarriage, neonatal death, premature rupture of membranes (PROM), premature birth, placental ablation, fetal distress, intrauterine death, gestational diabetes mellitus (GDM), preeclampsia, surmaturation, polyhydramnios , oligohydramnios, presentation anomaly, multiple pregnancy, intrauterine growth retardation (IUGR), postpartum hemorrhage, placenta previa, maternal and fetal outcomes in three pregnant groups were evaluated. Results: Normal spontaneous vaginal delivery (NSVD)/Cesarean section (C/S)" parameter was found to be significantly higher in pregnant women aged 45 and above, while it was found to be significantly lower in the group aged 16 and below(p<0.0001). Spontaneous abortion, on the other hand, was not found significantly in the 16-year-old and younger group compared to the other groups, while it was significantly higher in pregnant women aged 45 and above(p<0.0001).The incidence of GDM was significantly higher in pregnant women aged 45 and over, but it was not determined in pregnant women aged 16 and younger (p=0.003). The incidence of preeclampsia was also found to be significantly higher in pregnant women aged 45 and over (p<0.0001). The incidence of polyhydramnios was significantly higher in the risky pregnant group than in the control group (p=0.015). The incidence of presentation anomaly was found to be significantly higher in pregnant women aged 45 and over (p=0.012). No statistically significant difference was found in other parameters. Conclusion : Both early adolescent pregnancies and very advanced age pregnancies have their own problems. The obstetrician should be aware of these in his approach to both groups.
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