Abstract: Objective To compare the clinical efficacy of conformal flap technique （Limberg operation combined with Karydakis operation） and Limberg operation in the treatment of sacrococcygeal pilonidal sinus. Methods A retrospective study was conducted on 40 patients who met the inclusion criteria and received treatment for large pilonidal sinus in the anorectal Department of Affiliated Hospital of Qingdao University from January 2021 to January 2023, and were divided into two groups according to the operation type： conformal flap group and Limberg flap group. Postoperative rehabilitation indexes of patients in the two groups were observed and compared： the time of negative pressure drainage tube removal, the time of complete suture removal after surgery, the pain score of the patient on the 1st and 3rd day after surgery （using VAS score）, postoperative complications （incision bleeding, incision infection, incision dehiss） and recurrence. Results The surgery was successful in both groups. The pain score of the conformal flap group was lower than that of the Limberg flap group on the first day after surgery, with statistical significance （P<0.05）, indicating that the conformal flap technique could reduce postoperative pain more than Limberg surgery. Drainage tube removal time and suture removal time were shorter in the conformal flap group than Limberg flap group, and the difference was statistically significant （P<0.05）. The results showed that postoperative recovery was faster in the conformal flap group than in the Limberg group. In terms of complications, there were two cases of incision complications in the conformal flap group （subcutaneous effusion in one patient, partial incision dehiscence in one patient）, and three cases of incision complications in the Limberg treatment group （subcutaneous effusion in two patients, partial incision dehiscence in one patient）. Conclusion Through retrospective study, Compared with the Limberg flap, the conformal flap is suitable for treating pilonidal sinuses with wide sinus tracts and long walking distance by retaining more normal tissue and lower injury, faster wound healing and lower pain score than Limberg flaps.

Key words: sacrococcygeal pilose sinus, conformal skin flap, limberg flap transfer, karydakis flap transfer

摘要： 目的 对比适形皮瓣技术（Limberg皮瓣联合Karydakis皮瓣）与Limberg皮瓣技术治疗骶尾部藏毛窦的临床疗效。方法 回顾性研究2021年1月至2023年1月在青岛大学附属医院肛肠科接受窦道宽大藏毛窦治疗的40例符合纳入标准的患者,根据术式分为两组：适形皮瓣组和Limberg 皮瓣组,观察比较两组患者术后切口恢复指标：负压引流管拔除时间、术后完全拆线时间、术后患者第1、3天的疼痛评分（采用VAS评分）,术后并发症（切口渗血、口感染、裂开）及复发情况。结果 两组患者手术顺利,适形皮瓣组术后第1天疼痛评分低于Limberg皮瓣组,差异具有统计学意义（P<0.05）,表明适形皮瓣技术较Limberg手术更能减少患者术后疼痛;引流管拔除时间、拆线时间适形皮瓣组较Limberg皮瓣组时间短,差异有统计学意义（P<0.05）。表明适形皮瓣组术后恢复较Limberg皮瓣组快,并发症方面适形皮瓣组有2例出现切口并发症（1例患者出现皮下积液、1例患者出现切口部分裂开）,Limberg治疗组有3例出现切口并发症（2例患者出现皮下积液、1例患者出现切口部分裂开）。两组术后少量病例切口出现轻微并发症,经换药后均完全治愈,无显著差异。随访期间,两组均无复发。结论 适形皮瓣对于治疗窦道宽大且走形距离长的藏毛窦相较Limberg皮瓣通过保留更多正常组织,手术损伤小,术后创面愈合较Limberg皮瓣相对较快,疼痛评分相对较低,更有优势。

关键词: 骶尾部藏毛窦, 适形皮瓣, Limberg 皮瓣转移术, Karydakis皮瓣转移术