ДОСВІД ЛІКУВАННЯ ПІЛОНІДАЛЬНИХ КІСТ З АБСЦЕСОМ У ДІТЕЙ

In 80 % of cases of pilonidal cyst (PC) patients come for medical help with complains of purulent-inflammatory process which is painful and greatly affects the quality of life. Treatment of PC with abscess usually is performing with incision and drainage and after conservative treatment of inflammatory process – excision with primer closure. However, when edges of the wound are closed primarily, surrounding tissues are under significant tension, which brings a high rate of complications. Single-stage skin-fascial plastics technique can reduce wound tension which helps to avoid it. Objectives. To provide a comparative analysis of the treatment of pilonidal cyst with abscess in children with single-stage and two-stage surgical treatment.  Material and methods. 43 cases of PC with abscess in children, aged 15 to 18, were analyzed. In 35 cases (Group II) we performed two-stage treatment. Initially, the abscess was opened and drained with a linear incision. The next stage was radical surgery by classical methods performing. In 8 cases (Group I) was performed one-stage radical excision of a PC with an abscess, followed by skin-fascial plastics in our own modification. We compared duration of hospitalization, duration of pain, wound healing time. The intensity of pain on the visual analog scale was recorded. Results. The longest wound healing time was observed in group II. The duration of hospitalization was 17 % longer in the two-stage treatment group. In the one-stage treatment group, 4.6 times fewer complications were recorded compared to the two-stage group, and no infectious complications were registered in this group at all. The pain intensity index when using one-stage skin-fascial plastic surgery was 70 % lower compared to the two-stage treatment group on the second and third days of treatment. Conclusions. 1. Skin-fascial plastics is an effective method for treating pilonidal sinus with abscess in children. The single-stage treatment group had 4.6 times fewer complications compared to the two-stage approach, with no  infectious complications recorded. 2. The use of skin-fascial plastics significantly improves quality of life. On the first postoperative day, the pain level was 17 % lower compared to the two-stage treatment, and by the second and third days, it was 70 % lower, indicating less surgical trauma and a faster recovery process.