Eficacia de la cura en ambiente húmedo frente a la cura seca en pacientes operados de sinus pilonidal. Revisión sistemática

[Efficacy of moist versus dry healing in patients with pilonidal sinus surgery. Systematic review]

  • Fernando Morenilla-Gandía EIR de Familia y Comunitaria. Departamento de Salud de Denia, Valencia (España)
Palabras clave: sinus pilonidal, cicatrizacion de heridas, posoperatorio, vendaje de heridas, enfermería

Resumen

Objetivo: Evaluar la efectividad de la cura en ambiente  húmedo frente a la cura seca en pacientes operados de sinus pilonidal sobre los resultados de tiempo de cicatrización, infección, dolor, coste económico, tiempo de baja hasta retomar las actividades diarias y número de recidivas. Métodos: Se realizó la búsqueda sistemática en las bases de datos PubMed, Cinahl, Cochrane Library, Web of Sciencie, ScienceDirect, Cuiden Plus y Dialnet, sin filtro de tiempo y     filtrando por “ensayos clínicos” o “ensayo” en aquellas que lo permitiese. Se empleó la herramienta RoB2 para evaluar el riesgo de sesgo asociado. Resultados: Se incluyeron un total de 8 artículos (n=367). El grupo intervención empleaba curas en ambiente húmedo mientras que los grupos controles empleaban la cura seca. Los tiempos de cicatrización fueron menores en la cura húmeda, así como la infección, el dolor, la ausencia laboral y las recidivas, pero el coste fue mayor. Conclusiones: Según los resultados de esta la revisión       sistemática, se pudo concluir que la cura por segunda intención en ambiente húmedo es más efectiva que la cura seca en pacientes operados del sinus pilonidal, aunque falta más cantidad y rigurosidad en la investigación sobre esta materia. 

ABSTRACT:

Objective: To evaluate the effectiveness of moist versus dry healing in patients with pilonidal sinus surgery on the results of healing time, infection, pain, economic cost, time off work until resuming daily activities and number of recurrences. Methods: We systematically searched PubMed, Cinahl, Cochrane Library, Web of Science, ScienceDirect, Cuiden Plus and Dialnet databases, without time filtering and filtering by "clinical trials" or "trial" in those that allowed it. The RoB2 tool was used to assess the associated risk of bias. Results: A total of 8 articles (n=367) were included. The intervention group used moist dressing while the control groups used dry dressing. Healing times were shorter in the moist dressing, as were infection, pain, absence from work and recurrences, but the cost was higher. Conclusions: According to the results of this systematic review, it could be concluded that second-attention wet healing is more effective than dry healing in patients operated on for pilonidal sinus, although there is a lack of more and rigorous research on this subject.

Citas

Shabbir J, Chaudhary BN, Britton DC. Management of sacro-coccygeal pilonidal sinus disease: a snapshot of current prac-tice. Int J Colorectal Dis. 2011 Dic; 26(12): 1619-20.

Søndenaa K, Andersen E, Nesvik I, Søreide JA. Patient char-acteristics and symptomsin chronic pilonidal sinus disease. Int J Colorectal Dis. 1995 Feb; 10(1): 39-42.

Doll D, Orlik A, Maier K, Kauf P, Schmid M, Diekmann M, et al. Impact of geography and surgical approach on recurrence in global pilonidal sinus disease. SciRep. 2019 Oct 22; 9(1): 15111.

Kumar S, Haboubi N, Chintapatla S, Safarani N. Sacrococcyg-eal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctology. 2003 Abr 1; 7(1): 3-8.

Luedi MM, Schober P, Stauffer VK, Diekmann M, Andereggen L, Doll D. Gender- specific prevalence of pilonidal sinus disease over time: A systematic review and meta-analysis. ANZ J Surg. 2021; 91(7-8): 1582-7.

Hodges RM. Pilo-Nidal Sinus. Boston Med Surg J. 1880 Nov 18; 103(21): 485-6.

Buie LA. Jeep Disease: (Pilonidal disease of mechanized war-fare). South Med J. 1944Feb; 37(2): 103-9.

Ministerio de Sanidad. Clasificación Internacional de Enferme-dades 10ª revisión, modificación clínica. Edición española [In-ternet]. 4ª ed. 2022. [acceso 30 de Enero de 2022]. Disponible en: https://eciemaps.mscbs.gob.es/ecieMaps/browser/met-buscador.html

Mallory FB. Sacro-coccoygeal dimples, sinuses, and cysts. Am. J. Med. Sci. 1892 Mar; 103(3): 263.

Hueston JT. The aetiology of pilonidal sinuses. Br J Surg. 2005 Dic 6; 41(167): 307-11.

King ES. The Nature of the Pilonidal Sinus. Aust N Z J Surg. 1947; 16(3): 182-92.

Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. ANZ J Surg. 1992 May; 62(5): 385-9.

Iesalnieks I, Ommer A, Petersen S, Doll D, Herold A. German national guideline on the management of pilonidal disease. Langenbecks Arch Surg. 2016 Ago; 401(5): 599-609.

Menegas S, Moayedi S, Torres M. Abscess Management: An Evidence-Based Review for Emergency Medicine Clinicians. J Emerg Med. 2021 Mar 1; 60(3): 310-20.

Kumar M, Clay WH, Lee MJ, Brown SR, Hind D. A mapping review of sacrococcygeal pilonidal sinus disease. Tech Colo-proctology. 2021; 25(6): 675-82.

Saber A. Modified Off-Midline Closure of Pilonidal Sinus Dis-ease. North Am J MedSci. 2014 May; 6(5): 210-4.

Martínez Sanz N, Peña Ros E, Sánchez Cifuentes A, Benavi-des Buleje JA, Albarracín Marín-Blazquez A. Técnica de Karydakis modificada para el tratamiento del sinus pilonidal gigante. Cir Esp. 2016 Dic 1; 94(10): 609-11.

McCallum IJD, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008 Abr 19; 336(7649): 868- 71.

Enriquez-Navascues JM, Emparanza JI, Alkorta M, Placer C. Meta-analysis of randomized controlled trials comparing differ-ent techniques with primary closure forchronic pilonidal sinus. Tech Coloproctology. 2014 Oct; 18(10): 863-72.

Palacios Baldoceda DJ. Reparación Plástica con Colgajo de Limberg en Seno Pilonidal Sacrococcigeo. Rev Argent Colo-proctol. 2020 Mar 9; 31(01): 34-41.

Bascom J. Pilonidal disease: Origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980 May 1; 87(5): 567-72.

Hany Emile S, Muslim Khan S, Hani Barsom S, Wexner SD. Karydakis procedure versus Limberg flap for treatment of pi-lonidal sinus: an updated meta-analysis of randomized con-trolled trials. Int J Colorectal Dis. 2021 Jul; 36(7): 1421-31.

Stauffer VK, Luedi MM, Kauf P, Schmid M, Diekmann M, Wieferich K, et al. Common surgical procedures in pilonidal si-nus disease: A meta-analysis, merged data analysis, and com-prehensive study on recurrence. Sci Rep. 2018 Feb 15; 8(1): 3058.

Bradley L. Pilonidal sinus disease: a misunderstood problem. Wounds UK. 2006 Mar 1; 2(1): 45-53.

Boletín canario de uso racional del medicamento del SCS. Uso racional del material de curas (I). Cura tradicional en heridas agudas. Gran Canaria: Servicio canario de la salud; 2014.

Boletín Farmacoterapéutico de Castilla La Mancha. Estrategia terapéutica de las heridas crónicas: Uso racional del material de curas. Castilla La Mancha: SESCAM; 2018.

Boletín canario de uso racional del medicamento del SCS. Uso racional del material de curas (II). Cura en ambiente húmedo. Gran Canaria: Servicio canario de la salud; 2014.

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editores). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 [monografía en internet. Cochrane; 2022. [acceso 03 de febrero de 2022]. Disponible en www.training.cochrane.org/handbook.

Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366.

McGuinness LA, Higgins JPT. Risk‐of‐bias VISualization (rob-vis): An R package and Shiny web app for visualizing risk‐of‐bias assessments. Res Synth Methods. 2021 Ene; 12(1): 55-61.

Viciano V, Castera JE, Medrano J, Aguiló J, Torro J, Botella MG, et al. Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus. Eur J Surg Acta Chir. 2000 Mar; 166(3): 229-32.

Sadati L, Froozesh R, Beyrami A, Nouri Khaneghah Z, Ahmad Elahi S, Faryab Asl M, et al. A Comparison of Three Dressing Methods for Pilonidal Sinus Surgery Wound Healing. Adv Skin Wound Care. 2019 Jul; 32(7): 1-5.

Marinović M, Cicvarić T, Grzalja N, Bacić G, Radović E. Applica-tion of wound dressing Molndal technique in clean and poten-tially contamined postoperative wounds--initial comparative study. Coll Antropol. 2011 Sep; 35(2): 103-6.

Banasiewicz T, Bobkiewicz A, Borejsza-Wysocki M, Biczysko M, Ratajczak A, Malinger S, et al. Portable VAC therapy improve the results of the treatment of the pilonidal sinus--randomized prospective study. Pol Przegl Chir. 2013 Jul; 85(7): 371- 6.

Ulas Biter L, Beck GMN, Mannaerts GHH, Stok MM, van der Ham AC, Grotenhuis BA. The use of negative-pressure wound therapy in pilonidal sinus disease: a randomized controlled trial comparing negative-pressure wound therapy versus standard open wound care after surgical excision. Dis Colon Rectum. 2014 Dic; 57(12): 1406-11.

Buluş H, Morkavuk B, Koyuncu A. Compare the effectiveness of using lyophilized collagen type i matrix with conventional treat-ment in open wound healing after surgery for pilonidal sinus. Nobel Med. 2012; 8(2): 98-101.

Ayhan Kayaoglu H, Özkan N, Faik Ersoy Ö, Çelik A. The effect of hydrogel use on wound healing in pilonidal sinus patients un-dergoing surgical therapy by lay open technique. Turk J Surg. 2006; 22(1): 26-9.

Mamaloudis I, Perivoliotis K, Zlatanos C, Baloyiannis I, Spyrida-kis M, Kouvata E, et al. The role of alginate dressings in wound healing and quality of life after pilonidal sinus resection: A ran-domised controlled trial. Int Wound J. 2022 Ene 18; 1-11.

Mohamadi S, Hossein Norooznezhad A, Mostafaei S, Nikbakht M, Nassiri S, Safar H, et al. A randomized controlled trial of ef-fectiveness of platelet-rich plasma gel and regular dressing on wound healing time in pilonidal sinus surgery: Role of different affecting factors. Biomed J. 2019 Dic; 42(6): 403-10.

Gohar MM, Ali RF, Ismail KA, Ismail TA, Nosair NA. Assess-ment of the effect of platelet rich plasma on the healing of op-erated sacrococcygeal pilonidal sinus by lay- open technique: a randomized clinical trial. BMC Surg. 2020 Sep 22; 20(1): 212.

Romain B, Mielcarek M, Delhorme JB, Meyer N, Brigand C, Rohr S, et al. Dialkylcarbamoyl chloride-coated versus alginate dressings after pilonidal sinus excision: a randomized clinical tri-al (SORKYSA study). BJS Open. 2020 Abr; 4(2): 225-31.

Kubat M, Karabulut Z, Şengül S. Effect of propolis on wound healing in sacrococcygeal pilonidal disease: A randomized con-trolled clinical trial. Pak J Pharm Sci. 2021 May; 34(3): 1063-7.

Aldemir M, Hamdi Kara I, Erten G, Taçyildiz I. Effectiveness of Collagenase in the Treatment of Sacrococcygeal Pilonidal Sinus Disease. Surg Today. 2003 Feb 1; 33(2): 106-9.

Giannini I, Andreoli R, Bianchi FP, Cavallaro V, Corno F, Gec-cherle A, et al. Effectiveness of topical use of Lietofix® in wound healing after pilonidalis sinus excision: a multicenter study by the Italian Society of Colorectal Surgery (SICCR). Tech Colo-proctology. 2019 Abr; 23(4): 373-8.

Yahya Boztug C, Karaagac Akyol T, Benlice C, Ali Koc M, Doganay Erdogan B, Ilhami Ozcebe O, et al. Platelet-rich plas-ma treatment improves postoperative recovery in patients with pilonidal sinus disease: a randomized controlled clinical trial. BMC Surg. 2021 Oct 21; 21(1): 373.

Walker AJ, Shouler PJ, Leicester RJ. Comparison between Eusol and Silastic foam dressing in the postoperative manage-ment of pilonidal sinus. J R Coll Surg Edinb. 1991 Abr; 36(2): 105-6.

Danne J, Gwini S, McKenzie D, Danne P. A Retrospective Study of Pilonidal Sinus Healing by Secondary Intention Using Negative Pressure Wound Therapy Versus Alginate or Gauze Dressings. Ostomy Wound Manag. 2017 Mar; 63(3): 47-53.

Stewart A, Donoghue J, Mitten-Lewis S. Pilonidal sinus: healing rates, pain and embarrassment levels. J Wound Care. 2008 Nov; 17(11): 468-74.

Koyuncu A, Karada H, Kurt A, Aydin C, Topcu O. Silver-impregnated dressings reduce wound closure time in marsupi-alized pilonidal sinus. EWMA J. 2010 Sep; 10(3): 25-7.

Cherkasov MF, Galashokyan KM, Startsev YM, Cherkasov DM, Pomazkov AA, Melikova SG. Effects of vacuum therapy on wound healing in sacrococcygeal area. Nov Khirurgii. 2019 Abr; 27(2): 153-60.

Spyridakis M, Christodoulidis G, Chatzitheofilou C, Symeonidis D, Tepetes K. The role of the platelet-rich plasma in accelerat-ing the wound-healing process and recovery in patients being operated for pilonidal sinus disease: Preliminary results. World J Surg. 2009; 33(8): 1764-9.

Contreras Fariñas R, Cazalla Foncueva A, Cordero Ponce M, Estepa Osuna MJ, Galafate Andrade Y, Moreno Verdugo A, et al. Estudio comparativo de dos procedimientos de cura tras la resección de quiste pilonidal mediante técnica abierta.Biblioteca Lascasas. 2015; 11(2).

International Clinical Trials Registry Plataform [base de datos de internet]. Irán: Universidad de Ciencias Médicas de Birjand [actualizada en febrero de 2018; acceso 54. 22 de Abril de 2022]. Disponible en: https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT201405288375N8.

ClinicalTrials.gov [base de datos de internet]. Irlanda: Hospital de Tallaght [actualizada en abril de 2019; acceso 22 de Abril de 2022]. Disponible en: https://clinicaltrials.gov/ct2/show/NCT03483480

Publicado
2023-04-30
Cómo citar
1.
Morenilla-Gandía F. Eficacia de la cura en ambiente húmedo frente a la cura seca en pacientes operados de sinus pilonidal. Revisión sistemática: [Efficacy of moist versus dry healing in patients with pilonidal sinus surgery. Systematic review]. Enferm Dermatol [Internet]. 30 de abril de 2023 [citado 14 de abril de 2024];17(48):23-0. Disponible en: https://enfermeriadermatologica.org/index.php/anedidic/article/view/178
Sección
Trabajos de Investigación