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Effects of a tissue sealing-cutting device versus monopolar electrocautery on early pilonidal wound healing: a
Alper Parlakgumus1, Ali Ezer, Kenan Caliskan
1Eskisehir Military Hospital, Clinic of General Surgery, Eskisehir, Turkey. aparlakgumus@yahoo.com
Background:
Monopolar electrocauterization produces thermal effects on neighboring tissues, causing tissue damage. Recently, tissue sealing-cutting devices, which are easy to use and achieve simultaneous selective sealing and cutting with less production of heat, have been used.
Objective:
The aim of this study was to investigate the effects of a tissue sealing-cutting device vs monopolar electrocautery on wound healing in the early postoperative period after pilonidal sinus surgery.
Design:
This study was a prospective randomized clinical trial.
Setting:
This study was conducted at Military Hospital, Eskisehir, Turkey.
Patients:
In total, 128 patients with chronic pilonidal disease were randomly assigned into 2 clinically comparable groups between December 2009 and June 2010.
Intervention:
Pilonidal sinus excision was performed with monopolar electrocautery in the control group (n = 64) and with a tissue sealing-cutting device in the study group (n = 64). Data regarding wound healing, demographic variables, history, physical examination findings, defect dimensions, and scores for a visual analog scale were recorded.
Main Outcome Measures:
The main outcomes measured were surgical site infection, early wound failure (dehiscence), and unhealed wound rate.
Results:
: Wound infection and dehiscence rates were significantly lower (P = .01 and .02), but the duration of surgery was significantly longer (P < .01) in the tissue sealing-cutting group. The unhealed wound rate was 12.5% in the electrocautery group and 4.7% in the tissue sealing-cutting group (P = .01). When the distance from the lowest margin to the anus was 5 cm or less, wound infection and dehiscence rates were lower in the tissue sealing-cutting group (P < .01 and .03).
Limitations:
We could not obtain data regarding the cost-effectiveness of the instruments.
Conclusions:
A tissue sealing-cutting device in pilonidal sinus surgery yields better wound healing than monopolar electrocautery.