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Postoperative Outcomes of Bascom Cleft Lift Versus Excision With Secondary Wound Healing for Pilonidal Sinus Disease: A Multicenter Retrospective Analysis.

Source: PubMed, NCBI / U.S. National Library of Medicine

Diseases of the colon and rectumHuurman Eleonora Anna, de Kort Jasper F, de Raaff Christel A L, et al.Published 11/1/2024Last synced 7/20/2026Status: syncedPMID: 39115207DOI: 10.1097/DCR.0000000000003402

Pilonidal sinus disease impacts a patient's quality of life. In the Netherlands, it is often treated with excision and secondary wound healing, which is associated with high recurrence rates and poor wound healing. The Bascom cleft lift, an alternative technique, has shown favorable healing times and recurrence rates. The present study compares successful wound healing, time to healing, complications, and recurrence rate between excision with secondary wound healing and Bascom cleft lift. This is a multicenter retrospective study. Three institutions in the Rotterdam region of the Netherlands participated in the study. Patients who underwent excision with secondary wound healing or Bascom cleft lift between July 2015 and August 2021 were included. Primary end points included the rate of successful wound healing and the time to achieve healing. Secondary end points included postoperative complications and the recurrence rate within 12 months after surgery. Of 272 patients, 128 underwent Bascom cleft lift and 144 patients underwent excision and secondary wound healing. Recurrent pilonidal sinus disease (47.7% vs 22.2%) and abscess history (53.1% vs 40.3%) were more common in the Bascom cleft lift group compared to excision with secondary wound healing. The median follow-up period at the outpatient clinic was 43 days. The wound healing rate was 84.4% after Bascom cleft lift versus 32.6% after excision and secondary wound healing ( p < 0.001), with a median time to wound healing o

Abstract

Pilonidal sinus disease impacts a patient's quality of life. In the Netherlands, it is often treated with excision and secondary wound healing, which is associated with high recurrence rates and poor wound healing. The Bascom cleft lift, an alternative technique, has shown favorable healing times and recurrence rates. The present study compares successful wound healing, time to healing, complications, and recurrence rate between excision with secondary wound healing and Bascom cleft lift. This is a multicenter retrospective study. Three institutions in the Rotterdam region of the Netherlands participated in the study. Patients who underwent excision with secondary wound healing or Bascom cleft lift between July 2015 and August 2021 were included. Primary end points included the rate of successful wound healing and the time to achieve healing. Secondary end points included postoperative complications and the recurrence rate within 12 months after surgery. Of 272 patients, 128 underwent Bascom cleft lift and 144 patients underwent excision and secondary wound healing. Recurrent pilonidal sinus disease (47.7% vs 22.2%) and abscess history (53.1% vs 40.3%) were more common in the Bascom cleft lift group compared to excision with secondary wound healing. The median follow-up period at the outpatient clinic was 43 days. The wound healing rate was 84.4% after Bascom cleft lift versus 32.6% after excision and secondary wound healing ( p < 0.001), with a median time to wound healing of 55 and 101 days, respectively ( p < 0.001). Complications were 28.9% for Bascom cleft lift versus 13.2% for excision and secondary wound healing ( p = 0.003). The rate of recurrent disease was 6.3% after Bascom cleft lift and 11.8% after excision and secondary wound healing ( p = 0.113). This study used a retrospective design, which makes it prone to selection bias and residual confounding. In addition, the short follow-up period adds to these limitations because a longer follow-up period may better identify true recurrence rates. The absence of collected patient satisfaction data, which is currently a common scientific issue, is also a deficiency. This retrospective study shows that Bascom cleft lift is superior to excision and secondary wound healing, given the higher percentage of patients with successful wound healing within a shorter time. See Video Abstract . ANTECEDENTES:La enfermedad de seno pilonidal afecta la calidad de vida del paciente. En los Pa&#xed;ses Bajos, a menudo se trata con escisi&#xf3;n y cicatrizaci&#xf3;n por segunda intensi&#xf3;n, lo que se asocia con altas tasas de recurrencia y mala cicatrizaci&#xf3;n de las heridas. La elevaci&#xf3;n de la hendidura de Bascom, una t&#xe9;cnica alternativa, ha mostrado tiempos de curaci&#xf3;n y tasas de recurrencia favorables.OBJETIVO:El presente estudio tiene como objetivo comparar la cicatrizaci&#xf3;n exitosa de la herida, el tiempo de cicatrizaci&#xf3;n, las complicaciones y la tasa de recurrencia entre la escisi&#xf3;n con cicatrizaci&#xf3;n secundaria de la herida y la elevaci&#xf3;n de hendidura tipo Bascom.DISE&#xd1;O:Este es un estudio retrospectivo multic&#xe9;ntrico.AJUSTES:Tres instituciones en la regi&#xf3;n de Rotterdam de los Pa&#xed;ses Bajos participaron en el estudio.PACIENTES:Se incluyeron pacientes sometidos a escisi&#xf3;n con cicatrizaci&#xf3;n secundaria o elecaci&#xf3;n de la hendidura tipo Bascom entre julio de 2015 y agosto de 2021.PRINCIPALES MEDIDAS DE RESULTADO:Los resultados primarios incluyeron la tasa de curaci&#xf3;n exitosa de la herida y el tiempo para lograr la curaci&#xf3;n. Los resultados secundarios incluyeron complicaciones posoperatorias y tasa de recurrencia dentro de los doce meses posteriores a la cirug&#xed;a.RESULTADOS:De 272 pacientes, 128 se sometieron a elevaci&#xf3;n de hendidura tipo Bascom y 144 pacientes a escisi&#xf3;n y cicatrizaci&#xf3;n secundaria. La ESP recurrente (47.7% frente a 22.2%) y los abscesos (53.1% frente a 40.3%) fueron m&#xe1;s comunes en el grupo de elevaci&#xf3;n tipo Bascom en comparaci&#xf3;n con la escisi&#xf3;n con cicatrizaci&#xf3;n secundaria de la herida. La mediana del per&#xed;odo de seguimiento en la consulta externa fue de 43 d&#xed;as. La cicatrizaci&#xf3;n de la herida fue del 84.4 % despu&#xe9;s del lifting de Bascom frente al 32.6 % despu&#xe9;s de la escisi&#xf3;n y la cicatrizaci&#xf3;n secundaria (p < 0.001), con una mediana de tiempo hasta la cicatrizaci&#xf3;n de la herida de 55 d&#xed;as y 101 d&#xed;as, respectivamente (p < 0.001). Las complicaciones fueron del 28.9% para el lifting tipo Bascom frente al 13.2% para la escisi&#xf3;n y cicatrizaci&#xf3;n secundaria (p = 0.003). La enfermedad recurrente fue del 6.3% despu&#xe9;s del lifting de hendidura tipo Bascom y del 11.8% despu&#xe9;s de la escisi&#xf3;n y cicatrizaci&#xf3;n secundaria (p = 0.113).LIMITACIONES:Dise&#xf1;o retrospectivo que lo hace propenso a sesgos de selecci&#xf3;n y confusi&#xf3;n residual. Adicionalmente, el corto per&#xed;odo de seguimiento del estudio aumenta a&#xfa;n m&#xe1;s estas limitaciones, ya que un seguimiento m&#xe1;s prolongado puede identificar mejor las verdaderas tasas de recurrencia. Por &#xfa;ltimo, una deficiencia es la ausencia de datos recopilados sobre la satisfacci&#xf3;n del paciente, lo que hoy en d&#xed;a es un problema cient&#xed;fico com&#xfa;n.CONCLUSIONES:Este estudio retrospectivo muestra que la elevaci&#xf3;n de hendidura tipo Bascom es superior a la escisi&#xf3;n y cicatrizaci&#xf3;n secundaria dado el mayor porcentaje de pacientes con curaci&#xf3;n exitosa de la herida en un tiempo m&#xe1;s corto. (Traducci&#xf3;n-Dr. Jorge Silva Velazco ).

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