Primary Closure of Pilonidal Sinus With Slide-Swing Skin Flap Compared With the Secondary Closure: A Single-Blinded Randomized Controlled Trial.

INTRODUCTION: There are many surgical approaches for sacrococcygeal pilonidal sinus disease (PSD) therapy, ranging from wide excision repair to less morbid excisions with primary/flap closure. The off-midline flaps, which shift the incision line away from the midline natal cleft, have been associated with lower recurrence rates than the conventional mid-line closure techniques. This single-blinded randomized controlled trial aims to compare the short/long-term efficacy and outcome of the slide-swing flap technique with the conventional secondary wound closure. METHOD AND MATERIALS: This study was a prospective randomized controlled trial conducted on patients with PSD. Patients were assigned into two groups: secondary closure (control) and slide-swing flap (trial). Patients were advised to visit the surgical clinic two times weekly for the two weeks after the operation for at least six months. RESULTS: In this study, 100 patients were enrolled. They were assigned into two groups of control, and trial. The mean age of all participants was 29.15 ± 8.36 years old (age range: 18-62 years old). The mean operation time was 39.65 ± 12.63 for both groups, with the control group being 29.70 ± 7.71 and the swing flap group 46.90 ± 7.81. Patient visual analog scale (VAS) scores in both groups revealed that the trial group was associated with lower VAS scores compared with patients who underwent secondary closure (p-value = 0.006). Also, the trial group demonstrated a higher rate of healing, better cosmetic outcomes, and quicker recovery time compared with the controls. CONCLUSION: Compared with secondary closure, the slide-swing flap was associated with excellent cosmetic outcomes, disease recurrence, and recovery time. Also, the post-operative complications were significantly lower compared with the traditional method.

Effect of Nectaroscordum koelzi Methanolic Extract on Acute and Chronic Inflammation in Male Mice.

INTRODUCTION: The present study deals with the effect of Nectaroscordum koelzi fruit extract on acute and chronic inflammation. METHODS: A total of 84 NMRI mice were used in this study. The effect of the extract on acute inflammation was analyzed by increasing vascular permeability via acetic acid and xylene induced ear edema among mice. The extract was evaluated in terms of effects on chronic inflammation by means of the cotton pellet test among mice. For the assessment of inflammation degree, the mice paw edema volume was measured by the plethysmometric test. RESULTS: The findings showed that the extract was effective on acute inflammation induced by acetic acid in mice. In the xylene ear edema, N. koelzi extract indicated a significant activity in mice. In the cotton pellet method, the methanol extract produced a significant reduction in comparison with the control and dexamethasone. Mice paw edema volume decreased with the extract. CONCLUSION: In general, the data from the experiments indicated that the methanol extract of N. koelzi has an anti-inflammatory effect on acute and chronic inflammation. However, the exact contributing mechanisms have not been investigated for the pharmacological effects.