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The Role of Vacuum-Assisted Wound Closure Therapy after the Surgical Treatment of the Pilonodal Sinus

https://doi.org/10.22416/1382-4376-2018-28-6-58-67

Abstract

Aim. This study is aimed at improving the treatment of patients with the pilonidal sinus (PS) by open wound healing methods.
Materials and methods. The study included 54 patients with PS. The main group consisted of 29 patients treated by an open (exposure) management technique and a subsequent vacuum-assisted wound closure therapy. The control group consisted of 25 patients treated with conventional ointment bandages.
Results. On the 8th day of vacuum-assisted therapy (VAC-therapy), the areas of granulation tissue were identified in 23 (79.3 %) and 10 (40.0 %) (p = 0.041) cases in the main group and the control group, respectively. Following one month of treatment, complete wound healing was observed in 24 (82.8 %) patients in the main group, with no patients in the control group showing signs of complete healing (p < 0.0001). Cytologically, starting from the 8th day of VAC-therapy, a decrease in inflammation was observed in 24 (82.8 %) patients in the main group, with the wound regenerative processes being recorded on the 16th day in 17 (58.6 %) patients (p < 0.05). The average rate of wound healing in the main group was significantly higher and equal to 2.15 ± 0.15 cm2/day, compared to the value of 0.76 ±0.18 cm2/day in the control group.
Conclusion. Vacuum-assisted wound closure therapy is an effective way to stimulate reparative processes during the open management of wounds after the surgical treatment of PS.
 
Aim. This study is aimed at improving the treatment of patients with the pilonidal sinus (PS) by open wound healing methods.Materials and methods. The study included 54 patients with PS. The main group consisted of 29 patients treated by an open (exposure) management technique and a subsequent vacuum-assisted wound closure therapy. The control group consisted of 25 patients treated with conventional ointment bandages.Results. On the 8th day of vacuum-assisted therapy (VAC-therapy), the areas of granulation tissue were identified in 23 (79.3 %) and 10 (40.0 %) (p = 0.041) cases in the main group and the control group, respectively. Following one month of treatment, complete wound healing was observed in 24 (82.8 %) patients in the main group, with no patients in the control group showing signs of complete healing (p < 0.0001). Cytologically, starting from the 8th day of VAC-therapy, a decrease in inflammation was observed in 24 (82.8 %) patients in the main group, with the wound regenerative processes being recorded on the 16th day in 17 (58.6 %) patients (p < 0.05). The average rate of wound healing in the main group was significantly higher and equal to 2.15 ± 0.15 cm2/day, compared to the value of 0.76 ±0.18 cm2/day in the control group.Conclusion. Vacuum-assisted wound closure therapy is an effective way to stimulate reparative processes during the open management of wounds after the surgical treatment of PS.
 

About the Authors

M. F. Cherkasov
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Dr. Sci. (Med.), Prof., Departmental Head.

344022, Rostov-on-Don, Nahichevansky per., 29.



K. M. Galashokyan
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Cand. Sci. (Med.), Ass. Prof

344022, Rostov-on-Don, Nahichevansky per., 29.



Yu. M. Startsev
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Cand. Sci. (Med.), Ass. Prof.

344022, Rostov-on-Don, Nahichevansky per., 29.



D. M. Cherkasov
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Cand. Sci. (Med.), Ass. Prof.

344022, Rostov-on-Don, Nahichevansky per., 29.



A. A. Pomazkov
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Cand. Sci. (Med.), Ass. Prof.

344022, Rostov-on-Don, Nahichevansky av., 29.



S. G. Melikova
Rostov State Medical University, Department of Surgical Diseases, Faculty of Continuing Medical Education and Professional Development.
Russian Federation

Senior Research Assistant.

344022, Rostov-on-Don, Nahichevansky per., 29.



V. Yu. Katsiyaev
Rostov Regional Pathoanatomical Bureau.
Russian Federation

Anatomical Pathology Specialist.

344015, Rostov-on-Don, Blagodatnaya str., 170A.



A. A. Matvienko
Rostov Regional Pathoanatomical Bureau.
Russian Federation

Cytologist.

344015, Rostov-on-Don, Blagodatnaya str., 170A.



References

1. Loganathan A., Arsalani Zadeh R., Hartley J. Pilonidal Disease: time to reevaluate a common pain in the rear! Dis Colon Rectum. 2012;55(4):491–3. DOI: 10.1097/dcr.0b013e31823fe06c

2. Sondenaa K., Andersen E., Nesvik I., Soreide J.A. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorect Dis. 1995;10(1):39–42. DOI: 10.1007/bf00337585

3. Lurin I.A., Tsema E.V. Etiology and pathogenesis of pilonidal disease. Coloproctology. 2013;3(45):35–49 (In Rus.).

4. Titov A.Yu., Kostarev I.V., Batischev A.K. Etiopathogenesis and surgical treatment of epithelial pilonidal sinus (Review of the literature). Rus J Gastroenterol Hepatol Coloproctol. 2015;25(2):69–78 (In Rus.).

5. McCallum I., King P.M., Bruce J. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 2007;17(4):cd006213.

6. Segre D., Pozzo M., Perinotti R., Roche B. The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol. 2015;19(10):607–13.

7. Spyridakis M., Christodoulidis G., Chatzitheofilou C., Symeonidis D. et al. The Role of the Platelet-Rich Plasma in Accelerating the Wound-Healing Process and Recovery in Patients Being Operated for Pilonidal Sinus Disease: Preliminary Results. World J Surg. 2009;33(8):1764–9. DOI: 10.1007/s00268-009-0046-y

8. Cherkasov M.F., Galashokyan K.M., Startsev Yu.M. et al. Vacuum therapy in the complex treatment of the pilonodal sinus. Pirogov Russian Journal of Surgery. 2017;1:58–62 (In Rus.). DOI: 10.17116/hirurgia2017158-62

9. Cherkasov M.F., Startsev Yu.M., Gluschenkov V.A., Galashokyan K.M. Patent 2559936 Russian Federation, IPC A 61 M 27/00, A 61 V 17/00. A method for treating the pilonodal sinus / Applicant and patent owner RostGMU. No. 2014142876/14; appl. 23.10.2014; publ. 20.08.2015, Byul. No. 23. 8 p. (In Rus.).


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For citations:


Cherkasov M.F., Galashokyan K.M., Startsev Yu.M., Cherkasov D.M., Pomazkov A.A., Melikova S.G., Katsiyaev V.Yu., Matvienko A.A. The Role of Vacuum-Assisted Wound Closure Therapy after the Surgical Treatment of the Pilonodal Sinus. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(6):58-67. (In Russ.) https://doi.org/10.22416/1382-4376-2018-28-6-58-67

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ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)