INFORCEMENT OF SACROCOCCYGEAL FASCIA IN THE SURGICAL TREATMENT OF PILONIDAL SINUS DISEASE
AIM: to improve results of the surgical treatment of pilonidal sinus disease. MATERIALS AND METHODS: 39 patients with sacrococcygeal pilonidal disease were included into study. They underwent a radical operation of pilonidal sinus with wound defect closure using Donaty adaptive sutures between 2011 to April 2012 at Voronezh Regional Hospital #1. 23 patients had chronic inflammation of pilonidal sinus in the stage of purulent fistula; 6 patients - a recurrent abscess; 3 patients - chronic inflammation in the infiltration stage; 6 patients - an inflammatory remission of pilonidal sinus; 1 patient was admitted by the emergency with acute inflammation in the infiltration stage. The basic group was presented by 18 patients with pilonidal sinus disease. During the excision of their pathologically changed tissues’ strengthening of the sacrococcygeal fascia before wound defect closing by oversewing with Donaty adaptive sutures was performed. The control group included 21 patients with pilonidal sinus. Their radical surgical treatment was not associated with sacrococcygeal fascia strengthening. RESULTS: the results of the study showed that despite the increase of the operative time (3,5 minutes) the postoperative complication rate is significantly reduced in patients of the basic group (33,3 % against 71,4 %); postoperative hyperthermia and antibacterial therapy duration is also reduced (0,8 days and 7,9 days, respectively). The length of bed regimen in the basic group is shortened up to 2,7 days to compare with the control group in which activation started on the 3,2 day. It allowed to reduce the length of hospital stay in the basic group up to 10,4 days. CONCLUSIONS: the method of wound defect closing after radical excision of pilonidal sinus with sacrococcygeal fascia strengthening before passing of suture ligatures through it appears to improve the results of the surgical treatment in patients with present pathology.