Treatment of Chronic Pilonidal Sinus Disease-Comparison between Z-plasty, Primary Closure, and Marsupialization

潛毛症治療－比較Z型皮瓣、完全縫合及造袋術之結果

10.7096/TJTSPS.201003.0016

陳信翰(Hsin-Han Chen)；劉家瑋(Ka-Wai Liu)；吳肇毅(Chao-I Wu)；周爾康(Erh-Kang Chou)；鄭旭棠(Hsu-Tang Cheng)；許永昌(Yung-Chang Hsu)；黃思銘(Ssu-Ming Huang)；張家寧(Sophia Chia-Ning Chang)

pilonidal sinus disease ； Z-plasty ； marsupialization ； primary closure

臺灣整形外科醫學會雜誌

19卷1期（2010 / 03 / 01）

16 - 24

英文

背景： 潛毛症是一種好發於股溝皮膚的一種疾病，文獻上記載了不同的治療方式，其治療主旨在於移除潛毛症之管道及預防復發，但到目前為止，外科醫師仍在找尋最完善的手術治療方式。 目的及目標： 這篇文章記載了我們治療潛毛症的不同手術經驗。 材料及方法： 從2002年12月至2009年9月，中國醫藥大學附設醫院總共有12位潛毛症之病患接受不同的手術治療，我們記錄了病患的年紀、性別、手術方式、住院之天數、傷口癒合之時間、感染及復發率等資料，病患之追蹤時間介於6到81個月不等。 結果： 12位病患當中有：9位(75%)是男性，另外3位(25%)是女性，平均年齡為25.6歲。當中有七位病患(58.3%)接受完全縫合，三位接受Z型皮瓣，兩位(16.7%)接受造袋術，而它們的平均住院天數分別為1.85、2.33及2.5天。Z型皮瓣平均傷口癒合時間為24.7天，完全縫合為34.9天，而造袋術則為48天。我們發現接受完全縫合之病患其併發症(2/7，28.5%)及復發率(3/7，42.9%)為三組中最高，而造口術及Z型皮瓣之病患則沒有併發症。Z型皮瓣及造口術病患術後有很好的結果，但造口術之病患需要較長的傷口照顧時間。 結論： Z型皮瓣為一簡單又有效之手術治療。相較於完全縫合及造口術，它有較低之併發症及復發率，而它勝於造口術在於術後照顧傷口較為方便簡單。

Background: Pilonidal sinus disease is a common problem that affects the skin of the natal cleft. Various treatments for pilonidal sinus disease have been described in the literature. The treatment involves eradication of the sinus tract and prevention of recurrence. Determining the optimal treatment remains a challenge for surgeons. Aim and Objectives: This article presents our clinical experience with different surgical options for the treatment of pilonidal sinus disease. Materials and Methods: From December 2002 to September 2009, 12 patients underwent different types of surgical treatment for pilonidal sinus disease at the China Medical University Hospital. The age and gender of the patients, surgical options, length of hospital stay (days), wound healing period (days), rate of surgical site infection, and recurrence rate were analyzed retrospectively. The follow-up period ranged from 6 to 81 months. Results: The patients comprised 9 (75%) males and 3 (25%) females with a mean age of 25.6 years. The primary closure method was applied to 7 (58.3%) patients, Z-plasty to 3 patients (25.0%), and marsupialization to 2 patients (16.7%), and the average length of hospital stay was 1.85, 2.33, and 2.5 days, respectively. The mean wound healing periods were 24.7 days in the Z-plasty group, 34.9 days in the primary closure group, and 48 days in the marsupialization group. The highest rates of complication (2/7, 28.5%) and recurrence (3/7, 42.9%) were observed in the primary closure group. There were no postoperative complications in the marsupialization and Z-plasty groups. The Z-plasty and marsupialization groups both showed satisfactory results, but the marsupialization group required a longer period of wound management. Conclusion: Z-plasty is a simple and easy treatment method. It may be a more preferable treatment option as compared to the primary closure method, due to lower rates of complication and recurrence. Compared to the marsupialization method, post-operative wound care is less complicated after the Z-plasty method.