Ersoz

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Clinically important but not statistically significant reduction in the days to heal an open wound following pilonidal sinus excision with the addition of hyperbaric oxygen


Clinical Bottom Line:

1. Apparent acceleration in time to epithelialisation but not statistically significant.

2. Trend to reduced period of time when symptoms that lead to complaints to the treating team.

Citation/s:1. Ersoz F, Arikan S, Sari S, Korpinar S, Ozcan O, Poyraz B, Purisa S, Toklu AS. Effect of hyperbaric oxygen treatment on pilonidal disease surgery. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2016 Nov 1;43(7):821-5


Corresponding author's name and fax:Akin Toklu astoklu@istanbul.edu.tr

Three-part Clinical Question: For post-operative adults with surgically excised pilonidal sinus defects left open to heal, does the addition of hyperbaric oxygen to standard care result in accelerated healing?

Search Terms:Pilonidal sinus surgery; open wound; surgical wound healing

 

The Study:Single-blinded randomised controlled trial without intention-to-treat.

The Study Patients:Adult male patients with pilonidal sinus for surgical excision for the first time. All involved tissue resected and laid open.

Control group (N = 12; 12 analysed): Standard surgical technique and wounds left to heal after being laid open. Daily saline irrigation.

Experimental group (N = 10; 10 analysed): As above with the addition of 18 sessions of 100% oxygen breathing for 90 minutes daily at 2.5 ATA six days each week for three weeks.

 

The Evidence:

Measure

Control Group

HBOT Group

Difference

95% CI

Mean

SD

Mean

SD

Days to complete epithelialisation

83

18

50

11

33

-174 to 240


 

 

 

 

 

Comments:

1. Randomisation by shuffling cards. Assessing surgeon from 2 weeks was blinded to allocation

2. No mortality of post-operative complications reported in either group.

3. Authors state that recurrence is the worst feature of this disease after operation, but have not assessed this outcome.

4. Authors report a statistically significant difference in days to epithelialisation using a t-test but this result is not confirmed by the analysis using our software.

5. Authors also report statistically lower serum albumin in the HBOT group but this does not seem likely to be clinically relevant (4.67 versus 4.31 g/dl).

6. Small trial with low power.

 

Appraised by:Mike Bennett m.bennett@unsw.edu.au ; Thursday, 12 November 2020

Email: Kill or Update By: November 2023 501133-174.216 to 240.216

 

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