Literature DB >> 21573899

Effectiveness of a drain in surgical treatment of sacrococcygeal pilonidal disease. Results of a randomized and controlled clinical trial on 803 consecutive patients.

Marco Milone1, Milone Marco, Mario Musella, Musella Mario, Giuseppe Salvatore, Salvatore Giuseppe, Maddalena Leongito, Leongito Maddalena, Francesco Milone, Milone Francesco.   

Abstract

PURPOSE: The aim of this study was to evaluate the influence of cavity drainage in the surgical treatment of sacrococcygeal pilonidal sinuses.
METHODS: The study was prospectively carried out in 803 patients randomized into two groups of respectively 401 and 402 patients. In the first group, primary excision and closure were associated with drainage of the wound; in the second group, the wound was not drained. We have analyzed time off work, time to walk without pain, time to sitting on the toilet without pain, recurrences, and wound infections. We have also evaluated the satisfaction rate and esthetic results.
RESULTS: On comparing time off work, time to walk without pain, and time to sitting on toilet without pain postoperatively, there were no significant differences between the two groups. A significant difference between the two groups with regard to wound infection rates (p = 0.5) and recurrence rates (p = 0.6) was not observed. In order to prevent prolonged inpatient stay and social intolerance, this study suggests that the post-operative period is tolerated by a few when a drain was used. The visual analog scale (VAS) in the drained group was 3.2 ± 0.9, and VAS in the non-drained group was 3.5 ± 0.9 with a significant statistical difference (p = 0.0001). As regards the cosmetic appearance of the scar after surgery, we achieved a high satisfaction rate among patients in either group with 82.9% good cosmetic results.
CONCLUSIONS: The use of a drain, in our experience, appears to be useless in achieving a quick healing of the sacral wound; in addition, it has a low satisfaction rate.

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Year:  2011        PMID: 21573899     DOI: 10.1007/s00384-011-1242-4

Source DB:  PubMed          Journal:  Int J Colorectal Dis        ISSN: 0179-1958            Impact factor:   2.571


  55 in total

Review 1.  Pilonidal cyst: cause and treatment.

Authors:  J H da Silva
Journal:  Dis Colon Rectum       Date:  2000-08       Impact factor: 4.585

2.  Simple and effective surgical treatment of pilonidal sinus: asymmetric excision and primary closure using suction drain and subcuticular skin closure.

Authors:  O F Akinci; A Coskun; A Uzunköy
Journal:  Dis Colon Rectum       Date:  2000-05       Impact factor: 4.585

3.  Simple primary closure for pilonidal disease.

Authors:  J Holm; L Hultén
Journal:  Acta Chir Scand       Date:  1970

4.  Comparison between three therapeutic modalities for non-complicated pilonidal sinus disease.

Authors:  H A Mohamed; I Kadry; S Adly
Journal:  Surgeon       Date:  2005-04       Impact factor: 2.392

5.  Adipo-fascio-cutaneous flaps in the treatment of pilonidal sinus: experience with 50 cases.

Authors:  Raghubir Singh; Nevil M Pavithran
Journal:  Asian J Surg       Date:  2005-07       Impact factor: 2.767

6.  Does technique alter quality of life after pilonidal sinus surgery?

Authors:  Tamer Ertan; Mahmut Koc; Erdal Gocmen; A Kessaf Aslar; Mehmet Keskek; Mehmet Kilic
Journal:  Am J Surg       Date:  2005-09       Impact factor: 2.565

7.  Outcome of chronic pilonidal disease treatment after ambulatory plain midline excision and primary suture.

Authors:  Adriano Tocchi; Gianluca Mazzoni; Marco Bononi; Vittorio Fornasari; Michelangelo Miccini; Andrea Drumo; Lidia Colace
Journal:  Am J Surg       Date:  2008-07       Impact factor: 2.565

Review 8.  Elliptical rotation flap for pilonidal sinus.

Authors:  Gürel Neşşar; Cüneyt Kayaalp; Canbek Seven
Journal:  Am J Surg       Date:  2004-02       Impact factor: 2.565

9.  Practical experience of a no abdominal drainage policy in patients undergoing liver resection.

Authors:  Yang-Il Kim; Yoon-Jin Hwang; Jae-Min Chun; Byung-Yeol Chun
Journal:  Hepatogastroenterology       Date:  2007 Jul-Aug

10.  Outpatient excision and primary closure of pilonidal cysts and sinuses. Long-term follow-up.

Authors:  C E Zimmerman
Journal:  Am J Surg       Date:  1984-11       Impact factor: 2.565

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  16 in total

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

Authors:  S A Käser; R Zengaffinen; M Uhlmann; C Glaser; C A Maurer
Journal:  Int J Colorectal Dis       Date:  2014-11-05       Impact factor: 2.571

2.  The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR).

Authors:  D Segre; M Pozzo; R Perinotti; B Roche
Journal:  Tech Coloproctol       Date:  2015-09-16       Impact factor: 3.781

3.  Commentary: letter to the editor "do smoking and obesity really do not have any negative influence on wound healing after surgery of pilonidal disease?" of Cuneyt Kayaalp.

Authors:  Dietrich Doll
Journal:  Int J Colorectal Dis       Date:  2014-10       Impact factor: 2.571

Review 4.  German national guideline on the management of pilonidal disease.

Authors:  I Iesalnieks; A Ommer; S Petersen; D Doll; A Herold
Journal:  Langenbecks Arch Surg       Date:  2016-06-16       Impact factor: 3.445

5.  Recurrence-free survival, but not surgical therapy per se, determines 583 patients' long-term satisfaction following primary pilonidal sinus surgery.

Authors:  Dietrich Doll; Markus M Luedi; Theo Evers; Peter Kauf; Edouard Matevossian
Journal:  Int J Colorectal Dis       Date:  2015-02-18       Impact factor: 2.571

6.  Intradermal absorbable sutures to close pilonidal sinus wounds: a safe closure method?

Authors:  Marco Milone; Mario Musella; Paola Maietta; Paolo Bianco; Caterina Taffuri; Giuseppe Salvatore; Francesco Milone
Journal:  Surg Today       Date:  2014-09       Impact factor: 2.549

7.  Pilonidal sinus surgery: could we predict postoperative complications?

Authors:  Marco Milone; Matteo Nd Di Minno; Paolo Bianco; Guido Coretti; Mario Musella; Francesco Milone
Journal:  Int Wound J       Date:  2014-06-03       Impact factor: 3.315

8.  Outpatient surgical procedures: which is the ideal teaching procedure for a resident surgeon?

Authors:  M Milone; M Musella; P Maietta; P Bianco; C Taffuri; G Salvatore; F Milone
Journal:  G Chir       Date:  2013 Nov-Dec

Review 9.  The role of drainage after excision and primary closure of pilonidal sinus: a meta-analysis.

Authors:  M Milone; M N D Di Minno; M Musella; P Maietta; P Ambrosino; A Pisapia; G Salvatore; F Milone
Journal:  Tech Coloproctol       Date:  2013-06-11       Impact factor: 3.781

10.  S-shaped wide excision with primary closure for extensive chronic pilonidal sinus disease.

Authors:  Kerem Karaman; Safak Ozturk; Cem Tugmen; Eyup Kebapcı; Sait Murat Dogan; Mutlu Unver; Mustafa Olmez; Cengiz Aydin
Journal:  Case Rep Surg       Date:  2014-06-02
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