Pilonidal Sinus Clinical Trial
Official title:
Multicenter Randomized Controlled Trial of Mobilized Gluteus Maximus Muscle Fascia Flap Versus Primary Closure in the Treatment of Primary and Recurrent Pilonidal Sinus Disease.
Surgical treatment is still gold standard for pilonidal sinus disease. Several surgical
techniques have been proposed to treat this disease in the last two decades. A new method -
midline excision of pilonidal sinus and wound closure using gluteus maximus fascia plasty
flap (GMFF) - was proposed recently as a new method of treatment that results in low
reccurence rate and good cosmetic results.
The aim of this study is to compare a new method (GMFF) with a traditional method (midline
excision and primary closure) in terms of recurrence rate, complications and patient
satisfaction with results.
Pilonidal sinus disease (PSD) is a rather rare benign condition (about 26 cases per 100,000
population) that affects primarily young adults. Because of purulent nature it is treated
with surgery only.
Traditional surgical techniques encompass midline excision of the purulent cyst and either
leaving the wound "lay open" for secondary closure or midline primary closure. The latter
method has a major drawback of high recurrence rate and very long healing and patient
disability periods. Therefore alternative techniques to close the wound after pilonidal sinus
excision were proposed. In some a muscular-cutaneous flaps are created and the wound is
closed in a Z- or Y- or other shape manner. The recurrence rate of these techniques is
significantly lower than with a traditional midline closure, but healing time and final
cosmetic results are far from ideal in patient view.
Recently a new method of wound closure was developed independently by a few groups that
includes bilateral mobilisation of gluteus maximus muscles fascia and midline closure of the
wound. Preliminary results demonstrated that this method leads to lower recurrence rate and
better cosmetic results because the natal cleft is saved.
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