Wieloetapowe leczenie powikłanej torbieli pilonidalnej z użyciem opatrunków podciśnieniowych – opis przypadku

© Borgis - Nowa Medycyna 4/2015, s. 115-119 | DOI: 10.5604/17312485.1193554

*Przemysław Ciesielski, Paweł Dutkiewicz

Summary
There are several methods of pilonidal cyst surgery described in the literature. These treatments relates only to typical localization or complicated cysts with the single skin fistula. In many available publications authors emphasizes the positive effect of negative-pressure wound therapy system in reducing the inflammatory infiltration, pain and time of hospital stay. This work presents a case of 25 year old male patient with pilonidal sinus and many distant skin fistulas occurring due to the spread of the inflammation on the buttocks and crotch and as a results of multiple incisions of abscesses. The patient were treated in phases with combined technique (abscess drainage, vacuum therapy followed by Karadakis surgery). The authors also point the diagnostic difficulties caused by the spread of the disease in different directions at once and when the exit of the fistula are faraway the source of disease such as in the case described in this publication. Treatment of complicated cases require a multi-stage proceedings with the involvement of different treatments. The combination of surgery and negative-pressure therapy exhibits a reduction of pain, shortening hospitalization and is well tolerated by the patient. Negative-pressure wound therapy compare to gravity drainage seems to be more effective method for reducing infiltration of tissue inflammatory process in anatomically difficult areas.

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