BACKGROUND: It has long been suspected that acute infection leads to less satisfactory results in soft tissue surgery. Its influence on long-term recurrence rate in primary pilonidal sinus surgery has not been investigated yet. PATIENTS AND METHODS: 583 patients (military cohort) were analyzed, comparing an incision and drainage (I&D) group preceding surgery (n = 286 pts) with a spontaneous abscess and empyema rupture group (n = 297 pts). Long-term recurrence rate up to 25 years following surgery was determined. RESULTS: The I&D group achieved a 20 year recurrence rate of 24 %, whereas the non-I&D-group had 35 % recurrences (p = 0.0034). Analyzing the subgroup with primary open wound treatment (n = 349 pts), the I&D group did significantly better after 20 years (16 % actuarial recurrence rate versus 34 %; p = 0.009; log-rank-test). CONCLUSIONS: Early I&D treatment preceding definite surgery for some weeks seem to give significant superior results compared to primary surgery without I&D. The combination of early I&D and asymmetric excision and out of the midline closure is expected to give even further improved results compared to this cohort. The optimum interval between I&D and definite surgery has still to be determined.
BACKGROUND: It has long been suspected that acute infection leads to less satisfactory results in soft tissue surgery. Its influence on long-term recurrence rate in primary pilonidal sinus surgery has not been investigated yet. PATIENTS AND METHODS: 583 patients (military cohort) were analyzed, comparing an incision and drainage (I&D) group preceding surgery (n = 286 pts) with a spontaneous abscess and empyema rupture group (n = 297 pts). Long-term recurrence rate up to 25 years following surgery was determined. RESULTS: The I&D group achieved a 20 year recurrence rate of 24 %, whereas the non-I&D-group had 35 % recurrences (p = 0.0034). Analyzing the subgroup with primary open wound treatment (n = 349 pts), the I&D group did significantly better after 20 years (16 % actuarial recurrence rate versus 34 %; p = 0.009; log-rank-test). CONCLUSIONS: Early I&D treatment preceding definite surgery for some weeks seem to give significant superior results compared to primary surgery without I&D. The combination of early I&D and asymmetric excision and out of the midline closure is expected to give even further improved results compared to this cohort. The optimum interval between I&D and definite surgery has still to be determined.
Authors: Heidi Sievert; Theo Evers; Edouard Matevossian; Christian Hoenemann; Sebastian Hoffmann; Dietrich Doll Journal: Int J Colorectal Dis Date: 2013-06-20 Impact factor: 2.571
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
Authors: V K Stauffer; M M Luedi; P Kauf; M Schmid; M Diekmann; K Wieferich; B Schnüriger; D Doll Journal: Sci Rep Date: 2018-02-15 Impact factor: 4.379
Authors: Tenzin Lamdark; Raphael Nicolas Vuille-Dit-Bille; Isabella Naomi Bielicki; Laura C Guglielmetti; Rashikh A Choudhury; Nora Peters; Dietrich Doll; Markus M Luedi; Michel Adamina Journal: Medicina (Kaunas) Date: 2020-07-09 Impact factor: 2.430
Authors: Janina Kueper; Theo Evers; Kai Wietelmann; Dietrich Doll; Jana Roffeis; Philipp Schwabe; Sven Märdian; Florian Wichlas; Björn-Dirk Krapohl Journal: GMS Interdiscip Plast Reconstr Surg DGPW Date: 2015-01-13