The operative treatment of pilonidal sinus is characterized by an increased rate of wound healing complications and late recurrences. The Limberg transposition flap is an easy method for covering the defect after excision of the pilonidal sinus. The flap smooths out the deep skin fold of the rima ani and counteracts in this manner an important pathogenetic factor of pilonidal sinus recurrence. Between 6/96 and 7/99 we treated 42 patients using this method without complications of wound healing or recurrences. Comparison of literature results of different operative treatments (open granulation, primary suture, Z-plasty) shows lessened complication and recurrence rates for the Limberg transposition flap, which is the method of choice for chronic pilonidal sinus nowadays.
Every complication of the sigmoid stoma means a restriction of patients' quality of life. The complications of 164 patients were analyzed retrospectively (1/1996-5/1999). Indications for creation of a sigmoid stoma were malignomas of the rectum (n = 109). Hartmann's operation with or without sigmoid resection was performed in 55 patients for different reasons. Reoperation for complications was necessary in 8 patients (4.9%). Stenosis of the stoma (n = 3) and peristomal hernia (n = 2) were the most frequent complications. Other indications for reoperation were a prolapse (n = 1) of the stoma, a peristomal abscess with consecutive cutaneous necrosis (n = 1) and a metastasis of rectal cancer at the stoma site (n = 1). Operation techniques for sigmoid stoma creation and its complications are described. The own operative results are completed in an optimal manner by the work of a stoma therapist taking care of the patients both during and after hospital stay.
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