Closed‐incision negative‐pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing

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Autori principali: Ida Kaad Faurschou, Marlene Julia Sørensen, Allan Gorm Pedersen, Simon Ladefoged Rasmussen, Rune Erichsen, Susanne Haas
Natura: Artículo Open Access
Pubblicazione: Wiley 2024
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author Ida Kaad Faurschou
Marlene Julia Sørensen
Allan Gorm Pedersen
Simon Ladefoged Rasmussen
Rune Erichsen
Susanne Haas
author_facet Ida Kaad Faurschou
Marlene Julia Sørensen
Allan Gorm Pedersen
Simon Ladefoged Rasmussen
Rune Erichsen
Susanne Haas
Ida Kaad Faurschou
Marlene Julia Sørensen
Allan Gorm Pedersen
Simon Ladefoged Rasmussen
Rune Erichsen
Susanne Haas
collection Wiley Open Access
contents Closed‐incision negative‐pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing Ida Kaad Faurschou Marlene Julia Sørensen Allan Gorm Pedersen Simon Ladefoged Rasmussen Rune Erichsen Susanne Haas Colorectal Disease AbstractAimDespite favourable outcomes in recurrence after off‐midline closure techniques in pilonidal surgery, between 18% and 40% of patients suffer from prolonged postoperative wound healing. The aim of this work was to investigate if closed‐incision negative‐pressure wound therapy (NPWT) promotes wound healing after Bascom's cleft lift (BCL) surgery for complicated pilonidal sinus disease compared with conventional drainage and dressing.MethodPatients were randomized to either NPWT for 4–7 days or loop‐vessel drain for 24 h and a dry dressing postoperatively. Healing was evaluated by a wound care nurse blinded for randomization at 2 and 12 weeks postoperatively (primary endpoint). Healing was defined as one or no closing defects of ≤5 mm and with no undermining.ResultsAlthough we had wanted to recruit 200 patients, the study was terminated at 118 patients (NPWT group, n = 60; control group, n = 58) after interim analysis. Patients were comparable by age, sex, body mass index, previous smoking status and indication for BCL surgery. At 2 weeks 12% of patients were healed in both the NPWT and control groups [risk difference = 0.00(95% CI −0.12 to 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 to 0.13), p = 0.82]. There was no significant difference in pain experienced postsurgery. In a symptom‐based questionnaire, the control group reported self‐esteem to be less affected (p = 0.015).ConclusionClosed‐incision negative‐pressure wound therapy did not significantly improve healing after BCL surgery for complicated pilonidal sinus disease. 10.1111/codi.17198 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/codi.17198
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spellingShingle Closed‐incision negative‐pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing
Ida Kaad Faurschou
Marlene Julia Sørensen
Allan Gorm Pedersen
Simon Ladefoged Rasmussen
Rune Erichsen
Susanne Haas
Colorectal Disease
Closed‐incision negative‐pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing Ida Kaad Faurschou Marlene Julia Sørensen Allan Gorm Pedersen Simon Ladefoged Rasmussen Rune Erichsen Susanne Haas Colorectal Disease AbstractAimDespite favourable outcomes in recurrence after off‐midline closure techniques in pilonidal surgery, between 18% and 40% of patients suffer from prolonged postoperative wound healing. The aim of this work was to investigate if closed‐incision negative‐pressure wound therapy (NPWT) promotes wound healing after Bascom's cleft lift (BCL) surgery for complicated pilonidal sinus disease compared with conventional drainage and dressing.MethodPatients were randomized to either NPWT for 4–7 days or loop‐vessel drain for 24 h and a dry dressing postoperatively. Healing was evaluated by a wound care nurse blinded for randomization at 2 and 12 weeks postoperatively (primary endpoint). Healing was defined as one or no closing defects of ≤5 mm and with no undermining.ResultsAlthough we had wanted to recruit 200 patients, the study was terminated at 118 patients (NPWT group, n = 60; control group, n = 58) after interim analysis. Patients were comparable by age, sex, body mass index, previous smoking status and indication for BCL surgery. At 2 weeks 12% of patients were healed in both the NPWT and control groups [risk difference = 0.00(95% CI −0.12 to 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 to 0.13), p = 0.82]. There was no significant difference in pain experienced postsurgery. In a symptom‐based questionnaire, the control group reported self‐esteem to be less affected (p = 0.015).ConclusionClosed‐incision negative‐pressure wound therapy did not significantly improve healing after BCL surgery for complicated pilonidal sinus disease. 10.1111/codi.17198 http://creativecommons.org/licenses/by/4.0/
title Closed‐incision negative‐pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.17198