SURGICAL TREATMENT OF RECURRENCE OF PILONIDAL CYSTS OF THE SACROCOCCYGEAL AREA USING CROSSLINKED POLYURETHANE ADHESIVE AND IZOTRETINOIN

Abstract

The aim was to improve treatment outcomes among patients with recurrence of pilonidal cyst of the sacrococcygeal area by comprehensive surgical treatment using cross-linked polyurethane adhesive and isotretinoin. Materials and methods. The analysis of surgical treatment of 120 patients with recurrence of pilonidal cyst of the sacrococcygeal area was carried out. The age of the patients ranged from 18 to 46 years; the average age was 27±1.2 years. The patients were divided into 2 groups depending on the method of treatment. In group 1 (60 patients), surgical treatment was carried out according to the method of economical median resection developed by the authors with double-row internal extraepidermal sutures in combination with a cross-linked polyurethane adhesive with immobilized albucide and prescription of isotretinoin at a dose of 0.5 mg/kg/d. In group 2 (60 patients), surgical treatment of pilonidal cysts was performed using the traditional method of median resection with interrupted cutaneous fixation sutures. The groups of patients were comparable in age and sex (p>0.05). The patients of both groups were prescribed antibiotic therapy: ciprofloxacin 500 mg and metronidazole 500 mg per os. All patients of both groups underwent surgical treatment under local anesthesia. Results and discussion. In the postoperative period, among 60 patients of group 1 who underwent surgical treatment according to the developed method in combination with the use of an adhesive composition, 3 (5%) patients had seroma of postoperative wound; there were no cases of wound infection, hematoma or recurrence of pilonidal cyst. Among 60 patients of group 2, 13 (21.7%) patients had seroma of postoperative wound. Postoperative wound infection was observed in 3 (5%) patients. The presence of hematoma was registered in 1 (1.7%) patient. Recurrence of the disease was observed in 9 (15%) patients in a period of 3 months to 2.5 years. A significant improvement of surgical treatment of pilonidal cysts was achieved in patients, who underwent surgery according to the developed method using an adhesive composition and medical therapy with antimicrobials and isotretinoin.

Keywords

• pilonidal cyst,polyurethane adhesive,wound closure with tissue adhesives,isotretinoin.