Undergraduate Medical Student Amrita School of Medicine
Introduction: Coccygectomy as a treatment option for chronic refractive coccydynia has shown high success rates. However, a high incidence of wound complications associated with it, such as wound dehiscence and surgical site infections, has been a rising concern. Various techniques have been employed to overcome these, such as paramedian incisions, curvilinear incisions, Z-plasty techniques, etc. We present a case series describing a novel method using a transverse incision for coccygectomy and assess the clinical outcomes and patient satisfaction with this approach.
Methods: Patients suffering from refractory Coccydynia, resistant to conservative therapies, who underwent Coccygectomy using a transverse skin incision between 2011 and 2023 were included in this study. Demographic data for all patients were collected from electronic medical records retrospectively. Informed consent was obtained from each patient for clinical photography for medical publication, adhering to institutional policies. The primary outcome measure assessed the postoperative wound healing. Secondary outcomes included evaluating Visual Analog Scale (VAS) scores and overall patient satisfaction.
Results: 16 patients (3 males and 13 females) fulfilled the inclusion criteria. The mean age of the study population was 29.5 years (range 7-55 years). 2 patients (12.5%) experienced wound dehiscence that required re-suturing, while 1 patient (6.25%) had a superficial wound infection which was treated with oral antibiotics. None of the patients had deep infection. The mean VAS improved from 8.5 ±1.5 (pre-operatively) to 3.2 ±2.8 (post-operatively). 13 patients had an excellent outcome after the procedure while 3 had a fair outcome.
Conclusion : A transverse skin incision appears promising as an alternative to the conventional midline incision, potentially lowering the incidence of delayed wound healing and surgical site infections.
.jpg)
