Abstract: Objective:To explore the application value of vacuum sealing drainage (VSD) in wound repair after resection of pilonidal sinus.
Methods:The retrospective crosssectional study were conducted. The clinical data of 11 patients with pilonidal sinus who were admitted to the ChinaJapan Union Hospital of Jilin University from April 2015 to June 2016 were collected. All the patients received resection of pilonidal sinus after preoperative antibiotic therapy, and then received postoperative VSD and regular treatments of antiinfection and dressing changes. Observation indicators: (1) treatment situations: surgical procedures, operation time, volume of intraoperative blood loss, gross specimens, results of postoperative pathological examination, postoperative treatment (VSD), growth condition of granulation tissue, duration of hospital stay and treatment expenses; (2) followup situations: cases with followup, followup time, wound healing, postoperative complications and disease recurrence. Followup using outpatient examination and telephone interview was performed to detect the wound healing, postoperative complications and disease recurrence up to July 2017. Measurement data with normal distribution were represented as ±s. Measurement data with skewed distribution were described as M(range).
Results:(1) Treatment situations: all the 11 patients underwent successful surgery for pilonidal sinus. The operation time and volume of intraoperative blood loss were respectively (79±19)minutes and (10±4)mL. Observation of gross specimens of 11 patients: hairs were scattered within the resected lesions in 7 patients, and hairs didn't found in 4 patients. Results of postoperative pathological examination of 11 patients: there were acute and chronic inflammation accompanied with granulation tissues in the subepithelial fibrous tissues, and discrete multinucleated giant cell reaction. Of 11 patients undergoing VSD, 9 received VSD material changes for 3 times, 2 received VSD material changes for once, and wounds were not sutured after VSD removal. The new granulation tissues of 11 patients were found at (5.9±1.3)days postoperatively. The duration of hospital stay and treatment expenses were respectively (33.3±8.3)days and (37 790±8 811)yuan. (2) Followup situations: 11 patients were followed up for 12-18 months, with a median time of 14 months. The wound healing time was (41.0± 9.0)days. Of 11 patients with followup, 10 were in the primary healing, 1 who was complicated with wound infection and abscess of wound deep surface underwent sacral wound incision and drainage, gauze packing and routine dressing change, and then wound healed completely. There was no recurrence in 11 patients during the followup.
Conclusions:The VSD has great application value in managing wounds after resection of pilonidal sinus, with a lower incidence of wound infection and smaller scar, and it is worth recommending to patients with wide wounds, high tension and serious infection.