Comparative analysis on the effect of Z‐plasty versus conventional simple excision for the treatment of sacrococcygeal pilonidal sinus: A retrospective randomised clinical study

Yang, Yongping; Yu, Ling‐Yun; Wang, Yi‐zhuo; Shi, Jian; Li, Jiannan; Shang, Fengjia; Wu, Jiao; Liu, Tong‐Jun

doi:10.1111/iwj.13315

Cited by 8 publications

(13 citation statements)

References 24 publications

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“…Although the complete recovery time was not measured, it was concluded that Z-plasty patients needed less time for total recovery than patients who underwent a simple excision. (32) B.N. Anandaravi et al compared two techniques in pilonidal sinus treatment: primary closure and laying open.…”

Section: 2-wound Healing Durationmentioning

confidence: 99%

Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus, A clinical trial

Vejdan,

Danesh,

Amirian

et al. 2023

Preprint

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Background The most important step in the treatment of a pilonidal sinus is eradication by surgical excision. Over the years, a wide variety of surgical techniques have been reported for wound closure, yet their management still poses a challenge. The current study compares the results of two different methods of wound management: secondary wound healing versus the Z-plasty surgical technique. Material and Method: The current clinical trial recruited 86 uncomplicated pilonidal sinus patients who were to undergo complete surgical excision of the pilonidal sinus. For wound healing, the 86 subjects were equally divided into two groups of 43 patients each. One group was selected for Z-plasty surgical wound closure and the other for the secondary healing mechanism. Outcomes measured for both groups consisted of demographic data, length of operation, complications, severity of pain, number of dressings, recurrence, and complete healing time. Result In both groups, there were no significant differences observed in demographic data (age, sex, and BMI). The number of dressings applied in the Z-plasty group was significantly fewer than that in the secondary wound healing group. The duration for complete wound healing among the Z-plasty subjects was statistically significantly shorter in comparison with the other study group. The length of operation for secondary wound healing patients was significantly shorter than that for the Z-plasty group. During the first 24 hours after surgical excision of the pilonidal sinus, the severity of pain, measured by the VAS (Visual Analogs Scale), was the same for the two groups. However, after the first 24-hour postoperative period, the severity of pain was significantly less for Z-plasty patients than for the secondary wound healing group (based on lower use of analgesics and higher satisfaction). Conclusion Z-plasty is a safe and effective procedure in terms of wound complications and recurrence rate. This method is also cost-effective and better received by patients, since its shorter healing time, easier wound care, and lower degree of pain facilitate a faster return to work. Therefore, Z-plasty can be considered an alternative to traditional treatment methods. Trial registration: The trial is registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT20111211008375N16) in 01/06/2018.

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Section: 2-wound Healing Durationmentioning

confidence: 99%

Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus, A clinical trial

Vejdan,

Danesh,

Amirian

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…5 Negative pressure drainage techniques have been found to stimulate granulation tissue growth, reduce edema and wound contamination, and accelerate wound healing. 6 Currently, there are limited clinical studies on the effectiveness of sinus resection combined with vacuum-assisted closure in the treatment of sacrococcygeal pilonidal sinus. In this study, we investigated the application value of sinus resection combined with closed negative pressure drainage of the wound surface in 62 patients with sacrococcygeal pilonidal sinus.…”

Section: Introductionmentioning

confidence: 99%

“…Negative pressure drainage techniques have been found to stimulate granulation tissue growth, reduce edema and wound contamination, and accelerate wound healing 6 . Currently, there are limited clinical studies on the effectiveness of sinus resection combined with vacuum‐assisted closure in the treatment of sacrococcygeal pilonidal sinus.…”

Section: Introductionmentioning

confidence: 99%

Effect of sinus resection combined with vacuum‐assisted closure on sacrococcygeal pilonidal sinus

Xiao

Zhao

Shen

et al. 2023

International Wound Journal

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This study was aimed at investigating the effect of sinus removal combined with vacuum‐assisted closure in the treatment of sacrococcygeal pilonidal sinus. From January 2019 to May 2022, 62 patients with sacrococcygeal pilonidal sinus were treated and their information was collected at our hospital. These patients were randomly divided into two groups: an observation group (n = 32) and a control group (n = 30). The control group underwent a simple sinus resection and suture, while the observation group received a sinus resection combined with closed negative pressure drainage of the wound. A retrospective analysis of the data obtained was conducted. Perioperative indicators, clinical efficacy, postoperative pain, complications, aesthetic effects, and satisfaction scores at six months after the operation were compared between the two groups, and the recurrence rate at six months after the operation was recorded. Through this study, we found that the observation group had significantly shorter surgery time, hospital stay, and return time compared with the control group (P < 0.05). Additionally, the observation group had a higher overall recurrence rate (ORR) of 100.00%, which was significantly better than the control group's ORR of 86.67% (P < 0.05). The visual analog scale (VAS) score at 6, 12, and 24 h after the operation was significantly lower in the observation group compared with the control group (P < 0.05). Although the differences were not significant (P > 0.05), the observation group had decreased white blood cell, neutrophil, and C‐reactive protein levels after the operation. Moreover, the total occurrence rate of postoperative complications in the observation group was significantly lower (6.25%) than that of the control group (26.67%; P < 0.05). The observation group also had significantly lower scores on the postoperative scar scale and higher satisfaction scores than the control group (P < 0.05). However, there was no significant difference in the postoperative recurrence rate between the two groups (P > 0.05). Our study demonstrated that sinus resection combined with vacuum‐assisted closure was more effective in treating sacrococcygeal pilonidal sinus compared with simple sinus resection and suture. This approach significantly reduced surgery time, hospital stay, and return time. It also effectively relieved postoperative pain, reduced the occurrence of postoperative complications, resulted in smaller postoperative scars, and yielded better aesthetic outcomes and higher patient satisfaction.

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“…Recurrent disease with its concomitant morbidity remains a concern, and no single therapeutic option has acquired general acceptability. [5–12]…”

Section: Introductionmentioning

confidence: 99%

“…Recurrent disease with its concomitant morbidity remains a concern, and no single therapeutic option has acquired general acceptability. [5][6][7][8][9][10][11][12] In recent years, people are more and more inclined to minimally invasive surgery. Minero et al [13] introduced a more minimally invasive approach for sacrococcygeal pilonidal disease named Endoscopic Pilonidal Sinus Treatment in 2013 (EPSiT).…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis on the effect of the endoscopic versus conventional treatment for pilonidal sinus: A meta-analysis of controlled clinical trials

et al. 2022

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Background: Pilonidal sinus is a common disease in the sacrococcygeal region. Although many treatments have been described in recent years, the recurrence of each method remains high. Surgeons did not reach a consensus on the preferred approach for pilonidal sinus. We carried out a meta-analysis of controlled clinical trials comparing the outcomes of endoscopic treatment versus conventional treatment for pilonidal sinus disease in this study.Methods: We performed a systematic literature search, and we used electronic databases such as PubMed/Medline, Embase, and the Cochrane library to search for the relevant literature comparing endoscopic management to other conventional treatments for pilonidal sinus disease. The primary outcome parameters were operative time, recurrence, postoperative complications and pain, and total healing time.Results: Six studies were included in the review. Endoscopic pilonidal sinus treatment had a lower overall complication rate than the conventional surgery group (risk ratio = 0.33 [0.19-0.58], P = .0001) and lower pain score with a weighted mean difference of −2.44 (95% confidence interval: (−3.96) to (−0.92), I 2 = 99%, P = .002). There was no significant difference in recurrence (risk ratio = 0.75, 95% confidence interval [0.30-1.90],P = .55). Compared to the excision followed by the primary closure technique, the operation time, time to complete wound healing, and satisfaction were similar.Conclusions: Endoscopic pilonidal sinus treatment is a unique and potential method of sacrococcygeal pilonidal disease treatment. The foremost benefits of this technique are mild postoperative pain, lower complications rate, and return to routine for a shorter time. However, due to the limited number of articles, we need to conduct more rigorous large-sample prospective randomized controlled trials to clarify the efficiency of endoscopic treatment for pilonidal cysts.Abbreviations: CI = confidence interval, EHSI = en-bloc excision and healing by secondary intention, EPC = excision and primary closure, EPSiT = endoscopic pilonidal sinus treatment, ERAS = enhanced recovery after surgery, NA = Not available, PSD = pilonidal sinus disease, RCT = randomized controlled trial, RR = risk ratio.

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Comparative analysis on the effect of Z‐plasty versus conventional simple excision for the treatment of sacrococcygeal pilonidal sinus: A retrospective randomised clinical study

Cited by 8 publications

References 24 publications

Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus, A clinical trial

Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus, A clinical trial

Effect of sinus resection combined with vacuum‐assisted closure on sacrococcygeal pilonidal sinus

Comparative analysis on the effect of the endoscopic versus conventional treatment for pilonidal sinus: A meta-analysis of controlled clinical trials

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