手术切除皮损并挂线引流治疗臀部反常性痤疮的效果

Application of surgical removal and setons abscess drainage management in patients with moderate and severe acne inverse at gluteal and perianal area

目的探讨手术切除皮损组织并挂线引流治疗臀部中重度反常性痤疮的临床效果。方法2016年6月至2020年8月,栖霞市中医医院皮肤科收治4例臀部反常性痤疮患者,男3例、女1例,年龄19~34岁,平均28岁。将皮损处及炎症浸润的脂肪组织一并切除达筋膜浅层;沿皮损外口用探针探明皮下窦道,置入橡皮引流条,厚敷料包扎。结果4例患者术后创面均一期愈合,创面修复良好,随访6个月未复发。1例患者由于术后未及时采取仰卧位而导致术后短时间出血较多外,其余3例患者均恢复良好。术后6个月复诊,皮损处修复较好,不影响肛门皮肤功能、未见新皮损、未复发。结论手术切除皮损并结合挂线对口引流是治疗中重度反常性痤疮的有效方法之一,值得临床应用。

Objective To investigate the application value and effect of surgical removal and setons abscess drainage in moderate and severe acne inverse.Methods A retrospective case study of 4 patients(3 males and 1 female with an average of onset of 28 years)with acne inverse at gluteal and perianal area in the Qixia Traditioal Chinese Medical Hospital of Shandong province between June 2016 and August 2020,The operative technique was based on the complete excision of the entire diseased skin and subcutaneous fatty tissue,down to the muscular fascia.The cavity was explored using a probe,two setons were placed in each of the fistula tracts,and the wound were covered with absorptive dressing.Results All the wounds in 4 patients healed primarily and showed no recurrence after surgery,execpt for one patient who did not take supine position in time after operation which resulted in more bleeding in a short time.The other patients recovered well.The patients were followed up for 6 months without affecting the anal skin function,skin lesions and recurrence.Conclusions The technique of wide surgical excision and setons abscess drainage is an effective method for moderate and severe acne inverse.