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Assessment of Acute Wound Healing using the Dorsal Subcutaneous Polyvinyl Alcohol Sponge Implantation and Excisional Tail Skin Wound Models.
Published on: March 25, 2020
Local administration of antibiotics by gentamicin-collagen sponge does not improve wound healing or reduce recurrence
Roland E Andersson1, Gudrun Lukas, Stefan Skullman
1Department of Surgery, Länssjukhuset Ryhov, 551 85, Jönköping, Sweden. roland.andersson@lj.se
Background:
Excision and primary suture for pilonidal disease is associated with a high rate of wound infection and recurrences. This randomized, controlled study was designed to analyze the effect of local application of a gentamicin-containing collagen sponge (Collatamp(®)) in reducing the wound infection rate and recurrences after excision of pilonidal sinus and wound closure with primary midline suture.
Methods:
From March 2003 to November 2005, 161 patients with symptomatic pilonidal disease were operated on at 11 hospitals with traditional wide excision of the sinus and all of its tracts. The patients were randomized to filling of the cavity with a gentamicin-containing collagen sponge (Collatamp(®)) before wound closure or to closure with no additional treatment. Information about the treatment allocation was hidden until the end of the study. Information about wound healing was noted at follow-up at the outpatient department after 2-4 days, 2 weeks, 3 months, and 1 year.
Results:
No statistically significant differences were observed between the groups during follow-up. Patients who received prophylaxis with Collatamp(®) had slightly fewer wounds with exudate at 2-4 days and 2 weeks of follow-up (2% vs. 10%, p = 0.051 and 57% vs. 65%, p = 0.325, respectively), a slightly larger proportion of healed wounds at 3 months follow-up (77% vs. 66%, p = 0.138) but not at 1 year (85% vs. 90%, p = 0.42, respectively), and slightly more reoperations (10% vs. 4%, p = 0.213).
Conclusions:
This randomized, controlled study showed no significant differences in the rates of wound infection, wound healing, and recurrences when a gentamicin-collagen sponge was added to the surgical treatment of pilonidal disease with excision and primary midline suture. This does not support the use of gentamicin-collagen sponge for the surgical treatment of pilonidal disease.
Insights
Adding a gentamicin-collagen sponge (Collatamp®) to surgical treatment for pilonidal disease did not significantly reduce wound infections or recurrences. This study suggests Collatamp® is not beneficial for this surgical procedure.
Area of Science:
- Surgical Innovation
- Wound Healing Research
- Infectious Disease Management
Background:
- Pilonidal disease treatment via excision and primary suture often leads to high rates of wound infection and recurrence.
- The study investigates the efficacy of local gentamicin-collagen sponge application to mitigate these complications.
Purpose of the Study:
- To evaluate the impact of gentamicin-collagen sponge (Collatamp®) on reducing wound infection and recurrence rates following pilonidal sinus excision and primary suture.
- To compare outcomes between patients receiving Collatamp® and those undergoing standard surgical closure.
Main Methods:
- A randomized controlled trial involving 161 patients with symptomatic pilonidal disease across 11 hospitals.
- Patients underwent wide excision of the pilonidal sinus, followed by randomization to either cavity filling with Collatamp® or standard wound closure.
- Wound healing was assessed at 2-4 days, 2 weeks, 3 months, and 1 year post-surgery.
Main Results:
- No statistically significant differences were found between the groups in wound infection, healing rates, or recurrence at 1-year follow-up.
- Slightly fewer wounds showed exudate in the Collatamp® group at early follow-up points (2-4 days, 2 weeks).
- A slightly higher proportion of healed wounds was observed at 3 months in the Collatamp® group, but this was not sustained at 1 year. Reoperation rates were slightly higher in the Collatamp® group.
Conclusions:
- The addition of a gentamicin-collagen sponge (Collatamp®) to surgical excision and primary suture for pilonidal disease did not demonstrate significant benefits in reducing wound infection or recurrence rates.
- The findings do not support the routine use of gentamicin-collagen sponges in the surgical management of pilonidal disease.
- Further research may be needed to explore alternative or adjunct treatments for improving outcomes in pilonidal sinus surgery.