ОЦІНКА ЕФЕКТИВНОСТІ ЗАСТОСУВАННЯ ШКІРНО-ФАСЦІАЛЬНОЇ ПЛАСТИКИ ДЛЯ ЛІКУВАННЯ ПІЛОНІДАЛЬНИХ КІСТ У ДІТЕЙ

The incidence of pilonidal cyst (PC) is 26 cases per 100,000. Despite the great amount of proposed surgical techniques, the frequency of disease recurrence remains high. One of the problems of surgical treatment is the need to eliminate the soft tissue defect after PC excision, which is the main substrate that leads to longer treatment duration, long-term incapacity, difficult return to normal daily activities and decreasing of the quality of life. Therefore, determining the methods of treatment of PC in children, which will help reduce the number of complications and relapses, reduce the duration of hospitalization, remains relevant.Objectives. To compare the results of PC removing with subsequent fascio-cutaneous flap surgery and PC removing with suturing of the wound edges to the sacrococcygeal fascia.Material and methods. Database of patients who were being treated for PC, aged 13 to 18 years, was analyzed. Patients were divided into 2 groups: group I included children who, after PC removing, underwent surgery of a soft tissue defect according to the method of fascio-cutaneous surgery in their own modification (n-25). Group II included patients who underwent PC removing with suturing of the wound defect to the bottom of the wound (n-40). Intra- and postoperative indicators and long-term results were evaluated. The analysis was carried out according to the following criteria: duration of hospitalization, pain and healing time, presence of complications and relapses of the disease.Results. The duration of surgery in both groups did not differ significantly and ranged from 30 to 50 minutes, as well as the average volume of blood loss: from 7 to 10 ml. No intraoperative complications were registered. The average length of hospitalization after surgery was almost the same in both groups. The duration of pain in the 1st group was twice as short (by 54%). The healing time in the sacrococcygeal fascia suturing group was 61% longer compared to that in group I. The number of postoperative complications in group IІ was four times greater than in the fascio-cutaneous flap surgery group. During the year of observation, recurrences of the disease were noted in 4 children. No recurrence was registered in the skin-fascial plastic group.Conclusions 1. The method of skin-fascial flap surgery allows to reduce the number of complications, to significantly reduce the duration of hospitalization, pain and wound healing time, compared to classical operative methods of treating pilonidal cysts in children; 2. The use of skin-fascial flap surgery allows you to avoid recurrences of the disease, which makes this method the method of choice for the treatment of pilonidal cysts in children.