Single-dose metronidazole vs 5-day multi-drug antibiotic regimen in excision of pilonidal sinuses with primary closure: a prospective, randomized, double-blinded pilot study

Chaudhuri, Amala; Bekdash, B.; Taylor, Aaron

doi:10.1007/s00384-005-0064-7

Cited by 21 publications

(25 citation statements)

References 15 publications

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“…Lundhus et al [20] found no difference between one and four days of metronidazole and ampicillin application. In contrast, Chaudhuri and co-workers [21] demonstrated a potential benefit of a 5-day multidrug antibiotic regimen compared to single-dose metronidazole. To keep a routine antibiotics regimen, we gave a single shot of ampicillin and sulbactam to all patients undergoing a flap technique independent of the degree of contamination.…”

Section: Discussionmentioning

confidence: 93%

Short-term results of Karydakis flap for pilonidal sinus disease

et al. 2007

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These data provide evidence that the Karydakis flap technique might be performed even in potentially infected tissue. Although a considerable number of wound-related complications was observed in the Karydakis flap group, the majority of patients had primary healing. Thus, from our viewpoint, the Karydakis flap seems to be a potential alternative to simple excision in infected pilonidal sinus disease.

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Section: Discussionmentioning

confidence: 93%

Short-term results of Karydakis flap for pilonidal sinus disease

et al. 2007

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“…Twoofthe patients with recurrences werei nt his group, but the number is too small to conclude about the importance of ap ostoperative antibioticr egimen. However,i th as recently been shown that abroad-spectrum 5-day regimen is superior to asingle dose antibiotic prophylaxis in preventing infection-related wound complications in PSD surgery with central excision and primary closure (10).…”

Section: Resultsmentioning

confidence: 99%

Introducing an Asymmetric Cleft Lift Technique as a Uniform Procedure for Pilonidal Sinus Surgery

et al. 2008

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Background and Aims: asymmetric techniques for surgery in pilonidal sinus disease (psd) have been reported to provide better results than simple excision and closure in the midline. the aim of this retrospective study was to evaluate the results after introducing the Bascom asymmetric cleft lift procedure in our hospital on aday care basis.Material and Methods: from atotal of 33 patients operated from april 2002 to september 2004 with the Bascom asymmetric cleft lift technique, we were able to contact 29 who were invited to afollow up study.eighteen (62%) of these patients accepted aconsultation in the outpatient clinic while 11 (38%) were interviewed by phone.Results: at follow up mean 17 (range 10-27) months after the operation 24 (83%) of the wounds were healed while recurrences were present in 5(17%) of the patients. In two of the patients with recurrences errors in the procedures were identified. further results related to pre-, per-and postoperative conditions are discussed in this paper.Conclusion: early results after surgery for psd with the Bascom asymmetric cleft-lift technique are promising. the technique has now become our standard procedure for treating chronic, symptomatic psd.

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“…2,3 In a re cent ran do mi sed study, a com bi nati on of cep ha los po rin and met ra ni da zo le gi ven in a ca se se ri es of pri mary mid li ne clo su re was ob ser ved to be mo re ef fi ci ent in in fec ti on con trol in com pa rison with sing le do se pre o pe ra ti ve met ra ni da zo le. 2 Anot her se ri es which emp lo yed pri mary clo su re reve a led that an ti bi o tic proph yla xis with a sing le dose of ce fa los po ri ne fa i led to pro vi de any ad van da ge over the pa ti ents re ce i ved no proph yla xis. 3 Alt hough off-mid li ne clo su re such as Kary da kis flap that we ro u ti nely use se ems to ha ve lo wer in fec ti on rates, 8 in fec ti on ra tes may re ma in high af ter Kary da kis pro ce du re when no an ti bi o tic proph yla xis is gi ven.…”

mentioning

confidence: 99%

“…1 Ho wever, sur gi cal si te in fec ti on ra tes still re ma in high in many se ri es. [2][3][4][5][6] In fact, wo und in fec ti on is the major ca u se of sur gi cal fa i lu re, sug ges ting that pe ri ope ra ti ve an ti bi o tic use may im pro ve the out co me. Un for tu na tely, a re cent sur vey con duc ted by Peter sen et al 7 sho wed that only one-third of the clini cal stu di es men ti o ned if an ti bi o tics we re used.…”

mentioning

confidence: 99%

“…A re cent ran do mi sed study from the Uni ted King dom compared two dif fe rent an ti bi o tic pro to cols. 2 The wo und in fec ti on ra te was sig ni fi cantly hig her in the gro up re ce i ving a sing le do se of sing le drug (met ra ni da zo le 500 mg IV) when compared to the gro up re ce i ving a com bi na ti on (ce fu ro xi me 1.5 g IV and met ra ni da zo le 500 mg IV pre o pe ra ti vely, and co-amo xic lav 375 mg p.o. t.i.d.…”

mentioning

confidence: 99%

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Single Dose Prophylactic Antibiotics May Not Be Sufficient in Elective Pilonidal Sinus Surgery: An Early Terminated Study

Seker¹,

Ugurlu²,

Ergül³

et al. 2011

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : The sur gi cal in fec ti on ra te is not low in so me se ri es of elec ti ve pi lo ni dal sinus sur gery des pi te sing le do se an ti bi o tic proph yla xis. This study was de sig ned to com pa re wo und in fec ti on ra te after a sing le do se and a 5-day in tra ve no us course of cefazolin plus met ra ni da zo le admi nis tra ti on in patients who were operated employing Kary da kis flap for pi lo ni dal si nus. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : A to tal of 50 pa ti ents were in vol ved in this pros pec ti ve ran do mi sed cli ni cal study. Kary da kis flap pro ce du re was used and a va cu um dra in was left in si tu in all ca ses. The pa ti ents were di vi ded in to two gro ups: Gro up 1 had eit her a sing le do se of 500 mg met ra ni da zo le plus 500 mg ce fa zo lin so di um IV for proph yla xis and Gro up 2 were sub jec ted to sa me pre o pe ra ti ve drugs IV follo wed by the ir oral ad mi nis tra ti on for fi ve days (Se fa zol 500 mg tab let plus Flagyl 500 mg tab let, twice a day). The sur gi cal si te in fec ti on ra te, to tal dra i na ge vo lu me and dra in re mo val ti me we re re cor ded. R Re e s su ul lt ts s: : The study was trun ca ted be ca u se of oc cu ren ce of an unac cep tab le in fec ti on rate, thus, 30 pa ti ents we re ab le to con ti nu e on the study. Fi ve sur gi cal si te in fec ti ons we re ob ser ved in 14 pa ti ents in Gro up 1 (35.71%) whe re as only one in fec ti on was re cor ded in 16 pa ti ents in Group 2 (6.25%). Alt ho ugh the tar get pa ti ent num ber was not re ac hed, the sta tis ti cal dif fe ren ce was alre ady ac hi e ved (p= 0.04). The me an to tal dra i na ge vo lu me was gre a ter in Gro up 1 than in Gro up 2 (91.42 v.s. 72.12 ml; p= 0.073). Ho we ver, the me an dra in re mo val ti mes we re si mi lar. C Co on nc c l lu u s si i o on n: : The wo und in fec ti on ra te is high in elec ti ve pi lo ni dal si nus sur gery. Sing le do se proph ylac tic an tibi o tic com bi na ti on may not be suf fi ci ent to avo id wo und in fec ti on in pi lo ni dal si nus sur gery in which Kary da kis flap tech ni qu e is used. K Ke ey y W Wo or rd ds s: : Pi lo ni dal si nus; sur gi cal wo und infec ti on; an ti bi o tic proph yla xis; ce fa zo lin Ö ÖZ ZE ET T A Am ma aç ç: : Pi lo ni dal si nüs ne de niy le elek tif cer ra hi uy gu la nan ve tek doz an ti bi yo tik prof lak sisi ya pı lan ba zı se ri ler de cer ra hi alan en fek si yo nu ris ki dü şük de ğil dir. Bu ça lış ma da pi lo ni dal si nüs ta nı sıy la Kary da kis tek ni ğiy le ame li yat edi len has ta lar da tek doz se fa zo lin-met ra ni da zol prof lak sisi ile ay nı kom bi nas yo nun beş gün lük uy gu la ma sı nın ya ra en fek si yo nu ora nı na et ki si araş tı rıl dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Bu pros pek tif ran do mi ze ça lış ma ya top lam 50 has ta da hil edil me si plan lan dı. Tüm has ta la ra Kary da kis flep ame li ya tı ya pıl dı ve va kum lu dren kul la nıl dı. Has ta lar ay nı an t...

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Single-dose metronidazole vs 5-day multi-drug antibiotic regimen in excision of pilonidal sinuses with primary closure: a prospective, randomized, double-blinded pilot study

Abstract: A broad-spectrum 5-day regimen is superior to 'single-shot' antibiotic prophylaxis in preventing infection-related wound complications. However, this study needs to be conducted in a larger number of patients to have statistical power.

Cited by 21 publications

References 15 publications

Short-term results of Karydakis flap for pilonidal sinus disease

Short-term results of Karydakis flap for pilonidal sinus disease

Introducing an Asymmetric Cleft Lift Technique as a Uniform Procedure for Pilonidal Sinus Surgery

Single Dose Prophylactic Antibiotics May Not Be Sufficient in Elective Pilonidal Sinus Surgery: An Early Terminated Study

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