Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Randomized Controlled Trial Clinical Trial
[Treatment of pilonidal sinus with excision and primary suture using a local, resorbable antibiotic carrier. Results of a prospective randomized study].
The excision of a pilonidal sinus with wound healing by second intention, often results in a long duration of treatment. On the other hand, primary suture after excision has a high rate of abscess formation. In a randomized study we treated 40 patients with excision of pilonidal sinus, insertion of a collagen sponge containing Gentamicin and primary suture (group 1) to prevent this abscess formation. ⋯ In group 1 only 7.5% of the patients had a postoperative abscess formation, in contrast to group 2, with an abscess rate of 52.5% and consecutive surgery (p less than 0.001). One year after the operation the recurrence rate was 0 in both groups. Considering the results mentioned, surgical excision of the pilonidal sinus in combination with insertion of a resorbable antibiotic sponge we recommend this therapy.
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Plexus brachialis anaesthesia is a common technique for hand and forearm surgery. If the distance between puncture site and plexus brachialis is to long the anaesthesia will be incomplete. If there happens a direct puncture and injection of anaesthetics in the nerves, neurological deficit can occur. ⋯ In these patients we perform the plexus brachialis anaesthesia under sonographical control. For the examination we use a linear 7.5-MHz transducer. The technique is presented.