scholarly journals Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Kamil Yildiz ◽  
Erkan Ozkan ◽  
Hacı Mehmet Odabaşı ◽  
Bülent Kaya ◽  
Cengiz Eriş ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pilonidal Sinus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Satisfaction Rate ◽  
Flap Procedure ◽  
The Mean

Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique.Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction.Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%).Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

scholarly journals Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany

2021 ◽  
Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Jan Gödeke
Keyword(s):  
Pilonidal Sinus ◽  
Regional Variation ◽  
Disease Incidence ◽  
Age Groups ◽  
Pilonidal Sinus Disease ◽  
National Guidelines ◽  
Reconstructive Procedures ◽  
Sinus Disease ◽  
The Mean ◽  
Almost All

Abstract Purpose Collective evidence from single-centre studies suggests an increasing incidence of pilonidal sinus disease in the last decades, but population-based data is scarce. Methods We analysed administrative case–based principal diagnoses of pilonidal sinus disease and its surgical therapy between 2005 and 2017 in inpatients. Changes were addressed via linear regression. Results The mean rate of inpatient episodes of pilonidal sinus disease per 100,000 men increased from 43 in 2005 to 56 in 2017. In females, the mean rate of inpatient episodes per 100,000 women rose from 14 in 2005 to 18 in 2017. In the whole population, for every case per 100,000 females, there were 3.1 cases per 100,000 males, but the numbers were highly variable between the age groups. There was considerable regional variation within Germany. Rates of inpatient episodes of pilonidal sinus disease were increasing in almost all age groups and both sexes by almost a third. Surgery was dominated by excision of pilonidal sinus without reconstructive procedures, such as flaps, whose share was around 13% of all procedures, despite recommendations of the national guidelines to prefer flap procedures. Conclusion Rates of inpatient episodes of pilonidal sinus disease in Germany rose across almost all age groups and both sexes with relevant regional variation. The underlying causative factors are unknown. Thus, patient-centred research is necessary to explore them. This should also take cases into account that are solely treated office-based in order to obtain a full-spectrum view of pilonidal sinus disease incidence rates.

scholarly journals Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

2020 ◽  
Vol 17 (21) ◽  
pp. 8072 ◽  
Author(s):  
Kulothungan Gunasekaran ◽  
Mudassar Ahmad ◽  
Sana Rehman ◽  
Bright Thilagar ◽  
Kavitha Gopalratnam ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Length Of Stay ◽  
Pulmonary Disease ◽  
Respiratory Virus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
The Mean

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters (n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay.

It is Not Just Cosmesis: Straight Laparoscopy with Stoma Site Extraction Improves Outcomes in Ulcerative Colitis Patients Undergoing Total Colectomy

2019 ◽  
Vol 85 (10) ◽  
pp. 1194-1197
Author(s):  
Ino Chough ◽  
Karen Zaghiyan ◽  
Gayane Ovsepyan ◽  
Phillip Fleshner
Keyword(s):  
Ulcerative Colitis ◽  
Length Of Stay ◽  
Group Versus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Study Cohort ◽  
Class Iii ◽  
Total Abdominal Colectomy ◽  
Postoperative Length ◽  
The Mean

Minimally invasive approaches to total abdominal colectomy (TAC) in ulcerative colitis (UC) patients include straight laparoscopy (SL), hand-assisted laparoscopic surgery (HALS), and robotics. In this study, short-term outcomes of patients undergoing SL and HALS TAC were compared. Prospectively collected data on UC patients undergoing TAC were tabulated. The study cohort included 36 (27%) patients in the SL group and 95 (73%) patients in the HALS group. The groups were comparable in terms of preoperative characteristics and demographics. The mean operative time was 151 (range, 73–225) minutes in the SL group versus 164 (range, 103–295) minutes in the HALS group ( P = 0.09). Total 48-hour IV morphine use was 30 (range, 0–186) mg in the SL group compared with 56 (0–275) mg in the HALS group ( P < 0.01). Although overall morbidity was comparable between the groups, Clavien-Dindo Class III complications did not occur in any of the SL group patients versus 11 (11%) of the HALS group patients ( P = 0.03). The postoperative length of stay was 3 (3–21) days in the SL group versus 5 (3–15) days in the HALS group ( P < 0.01). Compared with HALS, SL is associated with lower postoperative narcotic use and hospital length of stay in UC patients undergoing TAC.

scholarly journals Perioperative Outcomes Of Laparoscopic Hysterectomy: Comparison With Abdominal, Vaginal, And Robot-Assisted Surgical Approaches

2015 ◽  
Vol 8 (1) ◽  
pp. 52-60
Author(s):  
Slavcho T. Tomov ◽  
Grigor A. Gortchev ◽  
Latchesar S. Tantchev ◽  
Todor I. Dimitrov ◽  
Chavdar A. Tzvetkov ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Perioperative Outcomes ◽  
Surgical Approaches ◽  
Significant Linear Correlation ◽  
The Mean

SummarySelection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p<0.05), as well as a significantly shorter hospital length-of-stay when compared to the abdominal, robotic or vaginal hysterectomy groups (p<0.05). Regression analysis revealed significant linear correlation between operative time and body-mass index of laparoscopic hysterectomy patients (R2 =0.008; p=0.026). Complications emergence and hemotransfusion often prolonged the mean operative time significantly by 17.8 min (p=0.002) and 15.5 min, respectively (p<0.001). The rate of major complications was significantly higher in the laparoscopic vs. abdominal groups (p<0.05). Clinical outcomes in patients operated on with laparoscopic hysterectomy were better than in those operated with total abdominal and vaginal hysterectomy in terms of operative time and hospital length-of-stay. Prospective randomized multi-center studies would be desirable to further define the place of the modern minimally invasive hysterectomy approaches.

scholarly journals Delirium and Associated Length of Stay and Costs in Critically Ill Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Claudia Dziegielewski ◽  
Charlenn Skead ◽  
Toros Canturk ◽  
Colleen Webber ◽  
Shannon M. Fernando ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hospital Costs ◽  
Hospital Length ◽  
Mean Difference ◽  
Hospital Length Of Stay ◽  
The Mean ◽  
The Impact

Purpose. Delirium frequently affects critically ill patients in the intensive care unit (ICU). The purpose of this study is to evaluate the impact of delirium on ICU and hospital length of stay (LOS) and perform a cost analysis. Materials and Methods. Prospective studies and randomized controlled trials of patients in the ICU with delirium published between January 1, 2015, and December 31, 2020, were evaluated. Outcome variables including ICU and hospital LOS were obtained, and ICU and hospital costs were derived from the respective LOS. Results. Forty-one studies met inclusion criteria. The mean difference of ICU LOS between patients with and without delirium was significant at 4.77 days ( p < 0.001 ); for hospital LOS, this was significant at 6.67 days ( p < 0.001 ). Cost data were extractable for 27 studies in which both ICU and hospital LOS were available. The mean difference of ICU costs between patients with and without delirium was significant at $3,921 ( p < 0.001 ); for hospital costs, the mean difference was $5,936 ( p < 0.001 ). Conclusion. ICU and hospital LOS and associated costs were significantly higher for patients with delirium, compared to those without delirium. Further research is necessary to elucidate other determinants of increased costs and cost-reducing strategies for critically ill patients with delirium. This can provide insight into the required resources for the prevention of delirium, which may contribute to decreasing healthcare expenditure while optimizing the quality of care.

scholarly journals Are Only A Few Hours Adequate For Hospitalization Following Mini-Incision Open Appendectomy In Pediatric Patients?

2021 ◽  
Author(s):  
Paiboon Sookpotarom ◽  
Vichack Chakrapan Na Ayudhya ◽  
Vorapatu Tangsirapat
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Pediatric Patients ◽  
Open Appendectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Open Technique ◽  
The Mean ◽  
Surgical Condition ◽  
Mini Incision

Abstract Purpose- A very short hospital length of stay following an open appendectomy in children with acute simple appendicitis has never been mentioned yet in literature. The authors reviewed the outcome of these pediatric patients who were treated with the open technique.Methods -We retrospectively reviewed the medical records of the 115 consecutive patients who underwent open appendectomy from June 2017 to July 2021.Results- There were 84 patients whose appendices were inflammatory or suppurative and appendectomies were done only through McBurney’s point. Of these, the average age was 9.11 ± 2.67 years. The mean length of the incision was 1.95 ± 0.48 centimeters. Nearly one-third (25/85) could be discharged with 3 hours following surgery. Of the remaining cases, 9 patients were discharged within the same day.Conclusion- There were increased percentages of patients who were eligible for our criteria in each year. The confidence of both parents and the therapeutic team on this concept is of paramount importance affecting a shift of paradigm of this treatment of this very common surgical condition.

scholarly journals Effect of length time to surgery on postoperative hospital length of stay among neurosurgical patients

2020 ◽  
Vol 11 ◽  
pp. 144
Author(s):  
Yahya H. Khormi ◽  
Andrew Nataraj
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Outcome Variable ◽  
University Of Alberta ◽  
Postoperative Stay ◽  
Urgent Surgery ◽  
Neurosurgical Patients ◽  
Before And After ◽  
The Mean

Background: In most hospitals, inpatient urgent surgery is triaged based on the degree of urgency and time of surgical booking. A longer wait for semi-urgent surgery due to sharing resources between specialties might impact the postoperative course. The objective of this study is to determine the effect of length time to semi- urgent surgery on postoperative hospital length of stay among neurosurgical patients. Methods: A retrospective cohort study was conducted included all admitted adult patients placed on semi-urgent University of Alberta Hospital surgical list between 2008 and 2013. Linear and logistic regression analyses were performed. The main exposure variable was time from surgical booking to the time of surgery, and the outcome variable was time from surgery to discharge. Results: A total of 1367 neurosurgical cases were included in the study. The mean age was 54.3 years. The mean length of time in the hospital before and after surgery was 1.2 and 12.5 days, respectively. Overall, the time from booking to surgery did not affect the time from surgery to discharge. Increased age, higher ASA score, and surgeries performed after 24 h from booking in the group of patients who were discharged to another facility were associated with a longer postoperative stay. Conclusion: Neurosurgery patients booked for surgery to be done within 24 h waited longer to have their procedure completed. Overall, there was no significant association between length of time waiting for surgery and postoperative stay, although there was an increase in postoperative stays among patients who were discharged to another facility and had their surgeries performed after 24 h.

Comparison of two Different Surgical Modalities in the treatment of Pilonidal Sinus (Primary Closure and Open Technique)

2021 ◽  
Vol 15 (11) ◽  
pp. 2999-3001
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Imran Anwar ◽  
Muhammad Waqas Saleem ◽  
Sameen Tahir ◽  
Haroon Javaid Majid
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Open Technique ◽  
Sinus Disease ◽  
Closed Technique ◽  
Secondary Intention ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Pilonidal sinus is disease of young age andits prevalence is higher in men compared to women (almost twice).It is a disease that arises from hair follicles particularly present in the natal cleft. It occurs commonly in Jeep Drivers and hence gets the name from there “Jeep Drivers Disease” and also commonly occurs in Barbers. It leads to formation of abscesses and chronic wounds with discharge and pain. Disease can have huge impact on social life and quality of life. In most cases the treatment is incision and drainage. Study design: It is a case series study. Place and duration of study: Department of General Surgery at Shaikh Zayed Hospital Lahore from January 2019 to January 2021. Aim: To compare the relative effects of open and closed surgical techniques on the recurrence rate, rate of infection and time of healing for pilonidal sinus. Methodology: Patients with pilonidal sinus disease from January 2019 to January 2021 received surgical treatment either excision followed by primary closure as in closed technique (group A) or excision followed by leaving the wound open for healing by secondary intention as in open technique (group B). Surgical management is widely based upon two techniques open and closed. In open technique wound is left open and heals by secondary intention while in closed technique it is closed primarily and heals by primary intention. The better choice between these two techniques is still a topic of debate. Results: The most common age group for pilonidal sinus was between 16-25 years of age. The mean age came out to be 26.7 years. The mean healing time was 15 days in group A and 42 days in group B. The duration of hospital stay ranged between 2-8 days for group A and 5-16 days for group B. Early postoperative complications seen was infection in 1 patient (7.69%) in group A and 5 patients (35.71%) in group B and these cases were managed conservatively.1 (7.69%) case of aseptic gaping of wound after stitch removal was seen in group A and was managed with closed technique. Recurrences reported in group A was 1 case (7.69%) at 6 months and was surgically managed by open technique. There were a total of 4 (28.57%) recurrences which were left open to heal by granulation. Conclusion: It is concluded that better management option for pilonidal sinus disease is primary closure of defect. So it is suggested that management of pilonidal sinus disease should be individualized but preference must be given to closure of wound after excision. Keywords: Pilonidal sinus, Primary Closure, Open Technique.

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