PURPOSE: In this study, we investigated whether there is a factor that can aid determi nation of the preferred technique by comparing the early and late results of two different surgical techniques for the treatment of pilonidal sinus. METHODS: The medical records of 176 patients in whom the Limberg flap (LF) or V-Y flap techniques were applied for reconstruction after the excision were evaluated retrospectively. RESULTS: The development rates of postoperative hematoma, wound separation, wound infection, and seroma were 2.8%, 5.1%, 5.6%, and 6.3%, respectively, while total flap necrosis was not observed in any patient. Return to daily activities was achieved after a mean of 17.1 days (13 to 21 days) days in the LF group and 32.7 days (18 to 47 days) in the V-Y flap group. During the average follow-up of 65 months (36 to 110 months), nine patients (5.1%) developed recurrent disease. There was no difference between the two groups with respect to early surgical complications (P = 0.286) or disease recurrence (P = 0.094), whereas the resumption of daily activities was longer in patients with a V-Y flap (P < 0.001). CONCLUSION: The early postoperative and long-term results of the LF and V-Y flap techniques for the treatment of pilonidal sinus were similar. Because the resumption of daily activities at work is achieved later in patients undergoing the V-Y flap compared with the LF technique, patients' employment (or position in working life) must be considered when determining the most appropriate surgical technique.
Employment ; Follow-Up Studies ; Hematoma ; Humans ; Medical Records ; Necrosis ; Pilonidal Sinus ; Recurrence ; Seroma ; Wound Infection

In this study, we investigated the effect of different values of intra-abdominal pressure on bacterial translocation. Twenty-four Wistar-Albino rats were divided into four groups. The animals belonging to the Control group were not subjected to any increased intra-abdominal pressure. In groups I, II and III, an intra-abdominal pressure of 14, 20, and 25 mmHg, respectively, was established by carbon dioxide pneumoperitoneum for a period of 60 minutes. Four hours after the pneumoperitoneum, all animals were sacrificed to evaluate the degree of bacterial translocation at this time. Liver, spleen and mesenteric lymph nodes were excised under sterile conditions. Bacterial growth was assessed using standard bacteriological techniques and compared statistically. The Kruskal-Wallis and Mann-Whitney U tests were used for the statistical analysis. Different amounts of bacterial growth were found in all of the animals subjected to increased intra-abdominal pressure, except for the controls. Bacterial translocation was detected at an intra-abdominal pressure of 14 mmHg but this finding was not statistically significant (p > 0.05). There was a significant increase in bacterial growth in animals subjected to an intra- abdominal pressure of 20 mmHg or above (p < 0.001). As a result, we found that bacterial translocation started when the intra-abdominal pressure reached a level of 14 mmHg. Patients should be closely monitored for septic complication risks following laparoscopic procedures in which the intra-abdominal pressure exceeds 20 mmHg.
Abdomen ; Animals ; *Bacterial Translocation ; Carbon Dioxide ; Laparoscopy/*adverse effects ; Pneumoperitoneum, Artificial/adverse effects ; Pressure ; Rats ; Rats, Wistar ; Splanchnic Circulation

OBJECTIVES: Mucosal free grafts may be successfully applied in many surgical interventions. This study aims at investigating the feasibility of palatal mucosa graft in sub-glottic field in an animal model. METHODS: This randomized prospective controlled study was conducted with an animal model. Sub-glottic inflammation was created in 15 adult rabbits in each group and sub-glottic stenosis surgery was applied thereafter. The rabbits in group 1 (control group) underwent segmental resection, partial cricoidectomy, and trachea-thyroid cartilage anastomosis; the rabbits in group 2 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free buccal mucosa graft; and the rabbits in group 3 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free palatal mucosa graft. Re-stenosis was evaluated after 42 days. RESULTS: The percentages of stenosis were 27%±20%, 40%±20%, and 34%±23% for group 1, 2, and 3, respectively and the difference was not statistically significant (P=0.29). Intensive and tight fibrosis was observed in 2 rabbits (13%) in group 1, in 5 rabbits (33%) in group 2, and in 3 rabbits (20%) in group 3. There was not a statistically significant difference between groups (P=0.41). Excessive inflammation was observed in 3 rabbits (20%) in group 1, in 7 rabbits (47%) in group 2, and 3 rabbits (20%) in group 3. There was no a statistically significant difference between groups although inflammation rate was higher in the rabbits which underwent buccal mucosa graft (P=0.18). CONCLUSION: The surgical treatments applied with free mucosa graft reduced anastomosis tension through enabling anastomosis to the distal of cricoid instead of thyroid cartilage. Free palatal mucosa grafts may be used in sub-glottic field, one of the most challenging fields of trachea surgery, due to ease of application and rapid vascularization.
Adult ; Autografts ; Cartilage ; Constriction, Pathologic* ; Fibrosis ; Humans ; Inflammation ; Models, Animal ; Mouth Mucosa ; Mucous Membrane* ; Prospective Studies ; Rabbits ; Thyroid Cartilage ; Trachea ; Tracheal Stenosis ; Transplants* ; Wound Healing