scholarly journals Recurrence rates after uncommon surgical procedures for pilonidal sinus disease

2019 ◽  
Vol 41 (2) ◽  
pp. 96-100
Author(s):  
T. Baur ◽  
V. K. Stauffer ◽  
A. P. Vogt ◽  
P. Kauf ◽  
M. Schmid ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease

Surgical reconstruction of pilonidal sinus disease with concomitant extracellular matrix graft placement: a case series

2021 ◽  
Vol 30 (Sup7) ◽  
pp. S28-S34
Author(s):  
Abigail E Chaffin ◽  
Shane G Dowling ◽  
Mychajlo S Kosyk ◽  
Brandon A Bosque
Keyword(s):  
Extracellular Matrix ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Case Series ◽  
Surgical Reconstruction ◽  
Pilonidal Sinus Disease ◽  
Surgical Approaches ◽  
Flap Reconstruction ◽  
Recurrence Rates ◽  
Sinus Disease

Background: Pilonidal sinus disease (PSD) is a chronic inflammatory disease affecting the soft tissue of the sacrococcygeal region and remains a challenging disease for clinicians to treat. The optimal treatment for PSD remains controversial and recent reports describe several different surgical approaches offering different benefits. Approximately 40% of initial incision and drainage cases require subsequent surgery. Due to high recurrence rates and postoperative complications, a more complex revision surgery involving a flap reconstruction may be required. We hypothesised that the combination of an extracellular matrix (ECM) graft with tissue flap reconstruction may decrease the postoperative complications and recurrence rates for PSD. Method: We report a retrospective case series using a surgical flap reconstruction with concomitant implantation of an ovine forestomach ECM graft under a fasciocutaneous flap with an off-midline closure for recurrent PSD, where previously surgical intervention had failed due to wound dehiscence and/or recurrent disease. Results: The case series included six patients. After three weeks, all patients except one were fully healed, and the sixth was fully healed by week 4; all wounds remained fully healed at 12 weeks. All patients achieved good cosmesis and were able to return to normal function without any residual symptoms. Conclusion: This pilot case series explored augmenting a flap reconstruction for complex PSD with advanced ECM graft materials, demonstrating that it may improve outcomes and minimise typical complications seen in flap closure, such as inflammation, infection, haematoma/seroma and hypoperfusion. Although the study had a limited number of participants, long-term outcomes were promising and suggest that further studies are warranted.

Comparison of Common Surgical Procedures in Non-complicated Pilonidal Sinus Disease, a 7-Year Follow-Up Trial

2019 ◽  
Vol 44 (4) ◽  
pp. 1091-1098 ◽  
Author(s):  
Mujgan Caliskan ◽  
Koray Kosmaz ◽  
Ismail Ege Subasi ◽  
Aylin Acar ◽  
Ismail Evren ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease

scholarly journals Anatomic effect of classical Limberg plastic surgery procedure in the sacro-coccygeal region for pilonidal sinus disease - A pilot study

2016 ◽  
Author(s):  
Michael Ardelt ◽  
Gregor Hallof ◽  
Rene Fahrner ◽  
Felix Dondorf ◽  
Stefan Ludewig ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Statistical Significance ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Rima Ani ◽  
Background Data ◽  
Male Patients

Abstract Objective Sacro-coccygeal pilonidal sinus disease is a frequent surgical problem. Some authors assign the low recurrence rates of the Limberg flap to the flattening or elevation of the natal cleft. Summery of the background data: Numerous authors describe a flattening or elevation of the natal cleft as a result of a Limberg flap that originated from the gluteal region. However, thus far these were not quantified. Methods The aim of our study was to quantify the flattening or elevation, respectively, of the natal cleft. In the context of our study on the Limberg flap plasty with a homogenous group of 12 male patients, we measured the depth of the rima ani after the excision and we also measured the thickness of the Limberg flap. Results The median thickness of the rima ani at excision was 3.35 cm [IQR: 2.70; 4.18]. The median thickness of the Limberg flap was 4.85 cm [IQR: 3.90; 5.18]. The thickness of the rima ani after excision was statistically significantly less as compared to the thickness of the Limberg flap (p = 0.002). Conclusion In our study, we have shown the elevation of the crena ani with statistical significance by performing the Limberg flap for the treatment of sacro-coccygeal pilonidal sinus disease, leading to a flattening of the sacro-coccygeal region. As a deep crena ani is a factor in the pathogenesis of pilonidal sinus, the flattening of the sacro-coccygeal region with a Limberg flap plasty, as reported in countless publications, may explain the low recurrence rates.

scholarly journals Karydakis procedure for sacrococcygeal pilonidal sinus disease: Our experience

2014 ◽  
Vol 47 (03) ◽  
pp. 402-406 ◽  
Author(s):  
N. Arun Kumar ◽  
Prasenjit Sutradhar
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Operative Time ◽  
Simple Procedure ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Stay Suture ◽  
Flap Procedure ◽  
Flap Repair

ABSTRACT Aim: The purpose of this study was to evaluate patients with sacrococcygeal pilonidal sinus disease (SPSD) who underwent Karydakis procedure at our centre with reference to the perioperative findings, early and late postoperative results and recurrence. Materials and Methods: A total of 103 patients presenting with SPSD at our centre underwent Karydakis flap repair from January 2001 to December 2010. These patients were then followed-up and evaluated with respect to operative time, drain use, hospital stay, suture removal, complications, and recurrence. Results: The mean operative time was 74.9 min with a median hospital stay of 5 days. Drains were removed at a median of 7 days and sutures at a median of 15 days. Twenty-one patients presented with serous collection in the wound. Six patients had wound infection. Patients were followed-up for a median of 29 months. No recurrences were noted in any of the cases. Conclusion: Karydakis flap procedure is a relatively simple procedure for SPSD with reproducible low recurrence rates.

scholarly journals Z Plasty Single Center Results in The Treatment of Pilonidal Sinus Disease in Children

2020 ◽  
Vol 2 (1) ◽  
pp. 39-43
Author(s):  
Yusuf Atakan Baltrak ◽  
Seniha Esin Sogut ◽  
Onursal Varlikli
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Common Chronic Disease ◽  
Sacrococcygeal Region ◽  
Surgical Methods

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Treatment varies according to the clinical presentation of the disease. Although many surgical methods have proposed, the ideal approach is still lacking due to high recurrence rates. This study aimed to evaluate the role of Z-plasty in achieving primary recovery in pilonidal disease and morbidity and recurrence. Twenty-four patients (15 males and nine females) who underwent sinus excision and Z-plasty closure for the sacrococcygeal pilonidal sinus included in this study. Follow-up ranged from 6 to 12 months. There were 15 males and nine females with a median age of 16 years. The mean hospital stay was two days. There was no recurrence, and all patients were satisfied with the cosmetics. Two patients (5%) had numbness on the flap. No flap necrosis observed in any patient. Only three patients had a wound infection (7.5%). Wound seroma developed in five patients (12.5%). Although some technical expertise is required, excision of sinus and Z-plasty provides superior results in terms of recurrence and hospitalization of pilonidal sinus patients during hospitalization.

scholarly journals Limberg Flap Reconstruction in Treating Sacrococcygeal Pilonidal Sinus

2019 ◽  
Vol 19 (1) ◽  
pp. 105-109
Author(s):  
Md Omar Faruk ◽  
Md Shahadot Hossain Sheikh ◽  
Mst Maksuda Parvin ◽  
Muhammad Ali Siddiquee ◽  
Md Jahangir Hossain Bhuiyan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Medical Science ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Reliable Technique ◽  
Sinus Disease ◽  
The Mean

Background: Pilonidal sinus is the relatively common condition affecting men almost twice as often as the women we experienced. The estimated incidence is 0.26 per thousand populations in general. The management of pilonidal sinus disease remains controversial, and gold standard treatment modality has yet to be established. Limberg procedure is a safe and reliable technique in the treatment of the sacrococcygeal pilonidal sinus disease, with a low complication and recurrence rates if performed according to the appropriate surgical principles. Methods: This is a Prospective study on 24 patients between the period from July 2014 to Dec 2018 in the Department of Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) as well as other different hospitals in Dhaka, Bangladesh. The patients having primary or recurrent pilonidal sinus disease underwent the foresaid surgical treatment. Results: Twenty four patients underwent this operation. Among them, the picture was that 20(83.3%) were males and 4(16.7%) were female. The mean age was 31, (Range: 17-45 years). 6(25%) patients were presented with recurrent sinus and 5 of them had one or more occasion previous surgery. Twenty one patients (87.5%) had full primary healing without any complication. But 1(4.2%) patient had minimal sarcoma, 1(4.2%) patient had superficial infection and the remaining other 1(4.2%) had partial flap necrosis. However, all three healed completely with conservative treatment. The mean length of hospital stay was 2.45 (Range: 1-5) days and the most patients returned to their work within 3 weeks. Conclusion: Limberg flap is very effective for sacrococcygeal pilonidal sinus disease with low complication rates, shorter hospital stay, low recurrence rates, earlier healing and reduced off-work period. The surgery can be easily mastered. We recommend Limberg flap as preferred surgery in the cases of Sacrococcygeal Pilonidal sinus. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.105-109

scholarly journals Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Dietrich Doll ◽  
Andriu Orlik ◽  
Katharina Maier ◽  
Peter Kauf ◽  
Marco Schmid ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Meta Analysis ◽  
Geographic Origin ◽  
Pilonidal Sinus Disease ◽  
Surgical Approaches ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
The Usa ◽  
The Impact

Abstract Pilonidal sinus disease (PSD) is increasing globally. A recent meta-analysis and merged-data analysis showed that recurrence rates in PSD depend essentially on follow-up time and specific surgical procedures. However, the global distribution of surgical approaches and respective recurrence rates have never been studied in PSD. We aimed at studying the impact of geographic distribution of surgical approaches to treat PSD and subsequent geography-specific recurrence rates. We searched relevant databases as described previously. Recurrence rates were then associated with reported follow-up times and geographic origin. We simulated individual patients to enable analogy across data. Globally, recurrence rates range from 0.3% for Limberg/Dufourmentel approaches (95% CI 0.2–0.4) and flaps (95% CI 0.1–0.5) and up to 6.3% for incision (95% CI 3.2–9.3) at 12 months. Recurrence rates range from 0.3% for Karydakis/Bascom approaches (95% CI 0.0–0.8) up to 67.2% for incision (95% CI 7.5–100) in the USA, and 0.0% for primary asymmetric closure in Germany (95% CI 0.0–0.0). Our analysis shows that recurrence rates in PSD not only depend on therapeutic approaches and follow-up time but also on geography. Primary asymmetric closure and various flap techniques remain superior regardless of the geographical region. Some approaches have extraordinarily good outcomes in specific countries.

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