Fulltext

Primary wound closure with a Limberg flap vs. secondary wound healing after excision of a pilonidal sinus: a multicentre randomised controlled study

Käser, S. ; Zengaffinen, R. ; Uhlmann, M. ; Glaser, C. ; Maurer, C.

In: International Journal of Colorectal Disease, 2015, vol. 30, no. 1, p. 97-103

Zum persönliche Liste hinzufügen
    Titel
    • Primary wound closure with a Limberg flap vs. secondary wound healing after excision of a pilonidal sinus: a multicentre randomised controlled study
    Autor
    • Käser, S.. Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, affiliated to the University of Basel, Rheinstrasse 26, 4410, Liestal, Switzerland
    • Zengaffinen, R.. Department of General, Visceral and Trauma Surgery, Hospital Centre of Oberwallis (SZO), Pflanzettastrasse 6, 3930, Visp, Switzerland
    • Uhlmann, M.. Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, affiliated to the University of Basel, Rheinstrasse 26, 4410, Liestal, Switzerland
    • Glaser, C.. Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, affiliated to the University of Basel, Rheinstrasse 26, 4410, Liestal, Switzerland
    • Maurer, C.. Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, affiliated to the University of Basel, Rheinstrasse 26, 4410, Liestal, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • International Journal of Colorectal Disease, 2015, vol. 30, no. 1, p. 97-103. Springer Berlin Heidelberg
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:332743
    Summary
    Purpose: Off-midline procedures seem to be the best method of primary wound closure after excision of a pilonidal sinus. Primary wound closure with a Limberg flap was compared to secondary wound healing. Methods: From January 2006 to July 2012, 102 patients with given informed consent (mean age 28years, men 81%) who had excision of a pilonidal sinus in three hospitals in Switzerland were randomised to group L (Limberg flap, n = 51) or to group E (excision only, n = 51). Primary endpoint was duration of incapacity for work. Follow-up was at 3weeks and at 1year postoperative (95% follow-up). Results: Both groups were comparable with regard to patient characteristics. The median (range) operation time was 60 (30-80) min in group L vs. 30 (10-75) min in group E (p < 0.001). No significant differences were found in postoperative pain and painkiller intake; pain, percentage of patients at work and overall satisfaction at 3weeks postoperative; and overall duration of incapacity for work and overall satisfaction at 1-year follow-up. The complication rate was 49% in group L vs. 12% in group E (p < 0.001). Complications in group L were seroma (6%), wound dehiscence (45%), skin necrosis (10%), hematoma (6%), infection (4%) and recurrent disease (13%). Complications in group E were recurrent disease (6%) and wound healing disorder (6%). Conclusions: After excision of a pilonidal sinus, primary wound closure with a Limberg flap has no advantage over secondary wound healing. The main reason for this conclusion is the relatively high complication rate of primary wound closure with a Limberg flap.