Abstract
Objective: We aimed to investigate if closed incision negative-pressure wound therapy (NPWT) promotes wound healing after Bascoms Cleft Lift (BCL) surgery for complicated pilonidal disease compared to conventional drainage and dressing.
Summary Background Data: Despite favorable outcomes in recurrence after off-midline closure techniques in pilonidal surgery, between 18-40% of patients suffer from prolonged postoperative wound healing.
Methods: Patients were randomized to either NPWT for 4-7 days or loop-vessel drain for 24 hours and a dry dressing post-operatively. Healing was evaluated by a wound care nurse blinded for randomization at 2 and 12 weeks postoperatively (primary endpoint). Healing was defined as ≤ 1 closing defect of ≤ 5 mm and no undermining.
Results: We aimed at inclusion of 200 patients. The study was terminated due to interim analysis after including 118 patients (NPWT group, n=60; control group, n=58). Patients were comparable by age, sex, BMI, previous smoking status, and indication for BCL surgery.
Only 12% of patients were healed 2 weeks after surgery in both the NPWT and control group (Risk Difference = 0.00(95% CI -0.12 – 0.11), p=1.00). After 12 weeks, 68 % of patients were healed in the NPWT group and 72% in the control group (Risk Difference = -0.03 (95% CI -0.19 – 0.13), p=0.82).
There was no significant difference in pain experience post-surgery. In symptom-based questionnaire, the NPWT-group reported significantly less annoyed with discharge after 2 weeks.
Conclusion: Closed incision negative-pressure wound therapy was not significantly different in improving healing after BCL surgery for complicated pilonidal disease.
Summary Background Data: Despite favorable outcomes in recurrence after off-midline closure techniques in pilonidal surgery, between 18-40% of patients suffer from prolonged postoperative wound healing.
Methods: Patients were randomized to either NPWT for 4-7 days or loop-vessel drain for 24 hours and a dry dressing post-operatively. Healing was evaluated by a wound care nurse blinded for randomization at 2 and 12 weeks postoperatively (primary endpoint). Healing was defined as ≤ 1 closing defect of ≤ 5 mm and no undermining.
Results: We aimed at inclusion of 200 patients. The study was terminated due to interim analysis after including 118 patients (NPWT group, n=60; control group, n=58). Patients were comparable by age, sex, BMI, previous smoking status, and indication for BCL surgery.
Only 12% of patients were healed 2 weeks after surgery in both the NPWT and control group (Risk Difference = 0.00(95% CI -0.12 – 0.11), p=1.00). After 12 weeks, 68 % of patients were healed in the NPWT group and 72% in the control group (Risk Difference = -0.03 (95% CI -0.19 – 0.13), p=0.82).
There was no significant difference in pain experience post-surgery. In symptom-based questionnaire, the NPWT-group reported significantly less annoyed with discharge after 2 weeks.
Conclusion: Closed incision negative-pressure wound therapy was not significantly different in improving healing after BCL surgery for complicated pilonidal disease.
| Originalsprog | Dansk |
|---|---|
| Tidsskrift | Colorectal Disease |
| ISSN | 1462-8910 |
| Status | Afsendt - 2024 |
Emneord
- pilonidal sinus
- Pilonidal disease
- pilonidal sygdom
- NPWT
- Negative-Pressure Wound Therapy