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The Infected Pilonidal Sinus – Comparison of Conservative versus Plastic Surgical Treatment after Excision

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Biofilm, Pilonidal Cysts and Sinuses

Part of the book series: Recent Clinical Techniques, Results, and Research in Wounds ((RCTRRW,volume 1))

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Abstract

The pilonidal sinus is a quite common sacral fistula. There is medical consent about the necessity of surgical excision in case of infection. But no gold standard of wound treatment after the excision has been established yet. Therapeutic options vary from conservative treatment inducing secondary wound healing to surgical interventions via primary wound closure (midline suture) up to plastic surgical reconstruction with local flaps (off-midline suture). Several clinical studies have clearly shown that the highest complication rate is found after primary wound closure. Off-midline procedures, including Limberg flap, Karydakis flap, and V-Y flap, exhibit a lower rate of recurrence than midline sutures and a shorter time of convalescence than secondary wound healing. In own studies we demonstrate that work absence is reduced, treatment time is shorter, and scar quality is improved after Limberg flap compared to secondary wound healing. To find the best treatment, however, large-scale studies need to be conducted to compare the different flaps to each other and to secondary wound healing.

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Klinikum Stadt Soest, Senator-Schwartz-Ring 8, 59494, Soest, Germany

    Sonja Dahmann M.D. & Max Vinzenz Meyer-Marcotty

  2. Department of Plastic Surgery, Medizinische Universität Graz (Medical University Graz), Auenbruggerplatz 29/4, A-8036, Graz, Austria

    Patricia Beatrice Lebo

  3. Medizinische Hochschule Hannover (Hannover Medical School), Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Max Vinzenz Meyer-Marcotty

Authors
  1. Sonja Dahmann M.D.
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  2. Patricia Beatrice Lebo
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  3. Max Vinzenz Meyer-Marcotty
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Corresponding author

Correspondence to Sonja Dahmann M.D. .

Editor information

Editors and Affiliations

  1. Tustin, CA, USA

    Melvin A. Shiffman

  2. Newport Beach, CA, USA

    Mervin Low

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Dahmann, S., Lebo, P.B., Meyer-Marcotty, M.V. (2017). The Infected Pilonidal Sinus – Comparison of Conservative versus Plastic Surgical Treatment after Excision. In: Shiffman, M., Low, M. (eds) Biofilm, Pilonidal Cysts and Sinuses. Recent Clinical Techniques, Results, and Research in Wounds, vol 1. Springer, Cham. https://doi.org/10.1007/15695_2017_14

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  • DOI: https://doi.org/10.1007/15695_2017_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-03076-6

  • Online ISBN: 978-3-030-03077-3

  • eBook Packages: MedicineMedicine (R0)

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