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Erschienen in: European Surgery 4/2014

01.08.2014 | Original Article

The effect of using methylene blue in surgical treatments of pilonidal disease: a prospective randomized study

verfasst von: A. Sahin, MD, E. Olcucuoglu, MD, D. Seker, MD, H. Kulacoglu, MD, FACS

Erschienen in: European Surgery | Ausgabe 4/2014

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Summary

Objectives

The aim of this study was to examine the effect of using intraoperative methylene blue (MB) in the treatment of pilonidal disease in the Karydakis flap practice on wound infection and recurrence and also by investigating other factors that affect wound infection and recurrence.

Patients and methods

In our research, the data of 231 patients, 129 of whom were in the MB [+] group and 102 of whom were in the MB [−] group, were obtained. Each patient’s age, gender, body mass index, whether they underwent pilonidal sinus surgery previously, the number of primary orifices, the number of secondary orifices, any preoperative infection, abscess drainage, and the use of antibiotic, if any, were recorded.

Results

The rate of postoperative wound infection in the entire group was found to be 25.1 %. While 19.4 % of the patients in MB [+] group had a wound infection, 32.4 % of the patients in the MB [−] group had a wound infection. The usage of MB was found to be a preventing factor in the occurrence of wound infection (p = 0.024).

Conclusion

MB is beneficial owing to its reducing effect on wound infections, which in turn is associated with a lower recurrence rate and a fast postoperative recovery. We suggest the use of MB at the beginning of acute or chronic pilonidal sinus surgeries, as MB is nontoxic and is of very low cost.
Literatur
1.
Zurück zum Zitat Chintapatla S, Safarani N, Kumar S, Haboubi N. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol. 2003;7:3–8.PubMedCrossRef Chintapatla S, Safarani N, Kumar S, Haboubi N. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol. 2003;7:3–8.PubMedCrossRef
2.
Zurück zum Zitat Armstrong JH, Barcia PJ. Pilonidal sinus disease. The conservative approach. Arch Surg. 1994;129:914–7. Discussion 917–9. Armstrong JH, Barcia PJ. Pilonidal sinus disease. The conservative approach. Arch Surg. 1994;129:914–7. Discussion 917–9.
3.
Zurück zum Zitat Akıncı OF, Bozer M, Uzunköy A, Düzgün SA, et al. Incidence and aetiological factors in pilonidal sinüs among Turkish soldiers. Eur J Surg. 1999;165:339–42.PubMedCrossRef Akıncı OF, Bozer M, Uzunköy A, Düzgün SA, et al. Incidence and aetiological factors in pilonidal sinüs among Turkish soldiers. Eur J Surg. 1999;165:339–42.PubMedCrossRef
4.
Zurück zum Zitat Urhan MK, Küçükel F, Topgül K, Özer I, Sari S. Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases. Dis Colon Rectum. 2002;45:656–9.PubMedCrossRef Urhan MK, Küçükel F, Topgül K, Özer I, Sari S. Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases. Dis Colon Rectum. 2002;45:656–9.PubMedCrossRef
5.
Zurück zum Zitat Bozkurt MK, Tezel E. Management of pilonidal sinüs with Limberg flap. Dis Colon Rectum. 1998;41:775–7.PubMedCrossRef Bozkurt MK, Tezel E. Management of pilonidal sinüs with Limberg flap. Dis Colon Rectum. 1998;41:775–7.PubMedCrossRef
6.
Zurück zum Zitat Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992;62:567–72.CrossRef Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992;62:567–72.CrossRef
7.
Zurück zum Zitat Doll D, Evers T, Krapohl B, Matevossian E. Is there a difference in outcome (long-term recurrence rate) between emergency and elective pilonidal sinus surgery? Minerva Chir. 2013;68(2):199–205.PubMed Doll D, Evers T, Krapohl B, Matevossian E. Is there a difference in outcome (long-term recurrence rate) between emergency and elective pilonidal sinus surgery? Minerva Chir. 2013;68(2):199–205.PubMed
8.
Zurück zum Zitat Doll D, Novotny A, Rothe R, Kristiansen JE, Wietelmann K, Boulesteix AL, Düsel W, Petersen S. Methylene blue halves the long-term recurrence rate in acute pilonidal sinus disease. Int J Colorectal Dis. 2008;32:181–7. Doll D, Novotny A, Rothe R, Kristiansen JE, Wietelmann K, Boulesteix AL, Düsel W, Petersen S. Methylene blue halves the long-term recurrence rate in acute pilonidal sinus disease. Int J Colorectal Dis. 2008;32:181–7.
9.
Zurück zum Zitat Seker D, Uğurlu C, Ergül Z, Akıncı M, Ölçücüoğlu E, Kulaçoğlu H. Single dose prophylactic antibiotics may not be sufficient in elective pilonidal sinus surgery: an early terminated study. Turkiye Klinikleri J Med Sci. 2011;31(1):186–90.CrossRef Seker D, Uğurlu C, Ergül Z, Akıncı M, Ölçücüoğlu E, Kulaçoğlu H. Single dose prophylactic antibiotics may not be sufficient in elective pilonidal sinus surgery: an early terminated study. Turkiye Klinikleri J Med Sci. 2011;31(1):186–90.CrossRef
10.
Zurück zum Zitat Allen-Mersh TG. Pilonidal sinus: finding the right track for treatment. Br J Surg. 1990;77:123–32.PubMedCrossRef Allen-Mersh TG. Pilonidal sinus: finding the right track for treatment. Br J Surg. 1990;77:123–32.PubMedCrossRef
11.
Zurück zum Zitat Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K. Primary closure techniques in chronic pilonidal sinus: a survey of the results of different surgical approaches. Dis Colon Rectum. 2002;45:1458–67.PubMedCrossRef Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K. Primary closure techniques in chronic pilonidal sinus: a survey of the results of different surgical approaches. Dis Colon Rectum. 2002;45:1458–67.PubMedCrossRef
12.
Zurück zum Zitat McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta analysis. BMJ. 2008;336:868–71.PubMedCentralPubMedCrossRef McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta analysis. BMJ. 2008;336:868–71.PubMedCentralPubMedCrossRef
13.
14.
Zurück zum Zitat Kitchen PR. Pilonidal sinus: excision and primary closure with a lateralised wound—the Karydakis operation. Aust N Z J Surg. 1982;52(3):302–5.PubMedCrossRef Kitchen PR. Pilonidal sinus: excision and primary closure with a lateralised wound—the Karydakis operation. Aust N Z J Surg. 1982;52(3):302–5.PubMedCrossRef
15.
Zurück zum Zitat Kitchen PRB. Pilonidal sinus: experience with the Karydakis flap. Br J Surg. 1996;83:1452–5.PubMedCrossRef Kitchen PRB. Pilonidal sinus: experience with the Karydakis flap. Br J Surg. 1996;83:1452–5.PubMedCrossRef
16.
Zurück zum Zitat Anyanwu AC, Hossain S, Williams A, Montgomery AC. Karydakis operation for sacrococcygeal pilonidal sinus disease: experience in a district general hospital. Ann R Coll Surg Engl. 1998;80:197–9.PubMedCentralPubMed Anyanwu AC, Hossain S, Williams A, Montgomery AC. Karydakis operation for sacrococcygeal pilonidal sinus disease: experience in a district general hospital. Ann R Coll Surg Engl. 1998;80:197–9.PubMedCentralPubMed
17.
Zurück zum Zitat Can MF, Sevinc MM, Yilmaz M. Comparison of Karydakis flap reconstruction versus primary midline closure in sacrococcygeal pilonidal disease: results of 200 military service members. Surg Today. 2009;39(7):580–6.PubMedCrossRef Can MF, Sevinc MM, Yilmaz M. Comparison of Karydakis flap reconstruction versus primary midline closure in sacrococcygeal pilonidal disease: results of 200 military service members. Surg Today. 2009;39(7):580–6.PubMedCrossRef
18.
Zurück zum Zitat Ates M, Dirican A, Sarac M, Aslan A, Colak C. Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg. 2011;202(5):568–73.PubMedCrossRef Ates M, Dirican A, Sarac M, Aslan A, Colak C. Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg. 2011;202(5):568–73.PubMedCrossRef
19.
Zurück zum Zitat Keshava A, Young CJ, Rickard MJ, Sinclair G. Karydakis flap repair for sacrococcygeal pilonidal sinus disease: how important is technique? ANZ J Surg. 2007;77(3):181–3.PubMedCrossRef Keshava A, Young CJ, Rickard MJ, Sinclair G. Karydakis flap repair for sacrococcygeal pilonidal sinus disease: how important is technique? ANZ J Surg. 2007;77(3):181–3.PubMedCrossRef
20.
Zurück zum Zitat Guttmann P, Ehrlich P. Über die Wirkung des Methylenblau bei Malaria. Berliner Klin Wochenschr. 1891;39:953–6. Guttmann P, Ehrlich P. Über die Wirkung des Methylenblau bei Malaria. Berliner Klin Wochenschr. 1891;39:953–6.
Metadaten
Titel
The effect of using methylene blue in surgical treatments of pilonidal disease: a prospective randomized study
verfasst von
A. Sahin, MD
E. Olcucuoglu, MD
D. Seker, MD
H. Kulacoglu, MD, FACS
Publikationsdatum
01.08.2014
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2014
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-014-0276-6

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