Results of surgical treatment of pilonidal sinus in 50 patients operated using Bascom II procedure - prospective study.

INTRODUCTION: Treatment of the pilonidal sinus, due to various surgical methods, remains the current topic of discussion during surgeon meetings worldwide. The newest methods of treatment consist in the excision and simultaneous closure of the wound with cleft lift procedures. One of such methods is Bascom II procedure which has been widely used in the world but is less popular in Poland. AIM OF THE STUDY: To evaluate the results of treatment of pilonidal cysts using Bascom II procedure performed by one operator. MATERIAL AND METHOD: 50 patients (40 men, 10 women), Avg. 30.6 years of age. All patients treated with Bascom II procedure in one surgical ward by one operator (resident during specialisation training) with the use of uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalisation time, pain, post-operative complications, wound healing time, patient's quality of life, and the recurrences rate after surgery. The follow-up period ranged from 12 to 52 months. RESULTS: Average BMI 27.13 kg / m2. Avg. time of hospitalisation 2.95 days. Post-operative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day on average 2.04 points (+/- 1.58 points); in the 30th day on average 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Post-oerative complications occurred in 28.57% of patients [partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%)]. The average time of full healing was 2.94 weeks. Recurrence occurred in one patient (2.04%). CONCLUSIONS: Bascom II procedure is characterised by a low recurrence rate and short wound healing time. It is a a safe, effective and patient-accepted method of treatment. Statistically, it significantly improves the patient's quality of life one year after surgery in terms of both physical and mental health.

New porcine model of perineal tear and its utility in physicians' training on the reconstruction of 3rd and 4th degree perineal tear during vaginal delivery.

OBJECTIVES: One of the most serious complications of vaginal delivery is 3rd and 4th degree perineal tear and its incorrect management results in anal incontinence. Animal-based anatomical models of childbirth-induced perineal tear are an important element of the physicians' practical training [1]. The proposed new model, prepared using porcine tongue and intestine, closely mimics all the tissues and organs subjected to injury during complicated deliveries and constitutes an educational opportunity for the reconstruction of the injuries. The objective of this paper was to present a new porcine model of the perineum and to evaluate the utility of this model in the training of physicians on the reconstruction of the 3rd and 4th degree perineal tear during childbirth. MATERIAL AND METHODS: We presented a preparation method of the proposed model and a calculation of the amount of time and costs required for its preparation. The utility of the model was assessed using a questionnaire completed by the participants of a workshop conducted with the model. RESULTS: We found that 95% of the respondents had never practiced perineal reconstruction on any model. According to 85% of the respondents, our model was very similar to natural tissues. According to 95% of the respondents, the simulated model of the perineal tear satisfactorily mimicked the real-life situation. CONCLUSIONS: The presented model is cheap and easy to prepare. It satisfactorily mimics the tissues and tissue injuries caused by the tear, making it helpful in training physicians on the reconstruction of 3rd and 4th degree perineal tear.