Letter to the Editor: Comparison of Common Surgical Procedures in Non-Complicated Pilonidal Sinus Disease, a 7-Year Follow-Up Trial

2021 ◽  
Author(s):  
Marius Dettmer ◽  
Markus M. Luedi ◽  
Dietrich Doll
Keyword(s):  
Surgical Procedures ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Letter To The Editor

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

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

scholarly journals Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature

2022 ◽  
Vol 8 ◽  
Author(s):  
Michele Manigrasso ◽  
Pietro Anoldo ◽  
Grazia Cantore ◽  
Alessia Chini ◽  
Anna D'Amore ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Endoscopic Treatment ◽  
Endoscopic Approach ◽  
Pilonidal Sinus Disease ◽  
Short Term ◽  
Sinus Disease ◽  
Video Assisted ◽  
Long Term Follow Up

Background: Pilonidal sinus disease (PSD) is a chronic troublesome pathology of the natal cleft of the sacrococcygeal region, with an estimated incidence of 26 cases in every 100,000 inhabitants. The aim of this review is to give a snapshot of the current literature on the endoscopic approach to PSD.Methods: A search on endoscopic treatment of pilonidal disease was performed according to PRISMA guidelines, adopting the following search terms: (pilonidal OR sacrococcygeal) and (endoscopic OR VAAPS OR EPSiT OR minimally invasive OR video-assisted OR video assisted).Results: Thirty-four articles were included in the final analysis, among which 23 were on adults and 11 were on pediatric population. The endoscopic approach is associated with painless postoperative pain, good aesthetic results, short time off work, and high patient satisfaction.Despite these advantages in short-term outcomes, results on recurrence rate in a long-term follow up are needed to definitively confirm the importance of this technique.Conclusions: The endoscopic approach is associated with significant postoperative advantages over other standard surgical approaches, and it should be included in the surgical portfolio for the treatment of PSD. According to the Italian guidelines, this technique could be considered as the gold standard for limited PSD. However, the favorable short-term-outcomes and lack of reliable data on long-term follow-up must be a stimulus to perform further high-quality studies to give definitive conclusions on this technique.

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

scholarly journals Outcome of Surgical Management of Sacrococcygeal Pilonidal Sinus Disease with Rotation Flap in 52 Patients—A Retrospective Study

2021 ◽  
Vol 54 (02) ◽  
pp. 163-167
Author(s):  
Abbas Mistry ◽  
Parvez Shaikh ◽  
Aizaz Mohammed ◽  
Samir Bagasrawala ◽  
Ankit Chauhan ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Suture Line ◽  
Pilonidal Sinus Disease ◽  
Radical Excision ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Rotation Flap ◽  
Post Surgery ◽  
Flap Closure

Abstract Background Surgical treatment of sacrococcygeal pilonidal sinus disease (SPSD) consists of radical excision of the entire tract and treatment of the resultant raw area. Here, the authors have reviewed the results of the rotation flap for closure of the SPSD. Aim This study aims to evaluate the outcomes following SPSD excision and rotation flap closure. Materials and Methods All patients were treated for SPSD with excision and closure using a rotation flap from January 2010 to September 2018. Cases having a follow-up of at least 6 months post surgery were evaluated. Result A total of 52 patients were included in the study; 42 cases were of primary disease while 10 were of recurrent disease. The patients’ follow-up records on the 3rd day, 10th day, 1 month, and 6 months were evaluated.None of the patients showed any signs of recurrence on follow-ups. One patient developed a hematoma on the third day post surgery which was treated conservatively. One patient developed a seroma in the perianal region on the fifth postoperative day which required aspiration. Both these patients healed well subsequently. Conclusion Rotation flap is a (simple and reliable) treatment option for closure of postexcision SPSD defect. It not only takes the tension away from suture line, but also pushes the gluteal fat from the sides into the midline, obliterating the deep crevice of the natal cleft which is believed to be one of the important factors in the causation of SPSD, thus minimizing recurrence.

scholarly journals Sinus Excision, Release of Coccycutaneous Attachments and Dermal-Subcuticular Closure (XRD Procedure): A Novel Technique in Flattening the Natal Cleft in Pilonidal Sinus Treatment

2008 ◽  
Vol 90 (5) ◽  
pp. 371-376 ◽  
Author(s):  
Deya M Marzouk ◽  
Ahmed A Abou-Zeid ◽  
Anthony Antoniou ◽  
Amyn Haji ◽  
H Benziger
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Normal Activity ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Novel Technique ◽  
Before And After ◽  
A New Technique

INTRODUCTION The objective of this study was to analyse, prospectively, the outcome of a new technique – excision of pilonidal sinus and flattening the natal cleft by division of the coccycutaneous attachments at the lower end of the incision. PATIENTS AND METHODS Sixty-six consecutive patients with chronic pilonidal sinuses were treated between 1995 and 2001. The procedure consisted of an elliptical, wide, local excision, release of the coccycutaneous attachments and primary closure using dermal-subcuticular closure (XRD). Suction drains were used until drainage was minimal. The height of skin level at the lower angle of the wound from the coccyx was measured intra-operatively before and after division of the coccycutaneous attachments. Postoperatively, patients were assessed for hospital stay, return to normal activity, complications and recurrence. RESULTS Sixty-four patients (97%) were males, median age 27 years. The height of skin level rose from a mean of 1.8 cm (95% CI, 1.78–1.85) to a mean of 3.8 cm (95% CI, 3.77–3.88; P < 0.001). Morbidity affected 12 patients (18%), epidermal separation of the lower wound angles (6 patients), seromas (5 patients) and 1 wound dehiscence at 2 weeks. All other wounds healed primarily without dehiscence. There were no recurrences after a median follow-up of 22.5 months (range, 12–38 months). CONCLUSIONS Release of the coccycutaneous attachments is an easy technique to learn, which seems to be an effective way of flattening the natal cleft and may result in lower recurrence rate. This technique should be tried in uncomplicated pilonidal sinus disease before more complex procedures are attempted.

scholarly journals Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

2012 ◽  
Vol 94 (1) ◽  
pp. 12-16 ◽  
Author(s):  
MR Venus ◽  
OG Titley
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Perforator Flap ◽  
Cosmetic Outcome ◽  
Pilonidal Sinus Disease ◽  
Wound Edge ◽  
Sinus Disease ◽  
Free Rate ◽  
The Ideal

INTRODUCTION The ideal treatment for pilonidal sinus disease has yet to be defined. There are many approaches described in the literature. METHODS Thirty-five consecutive patients who underwent wide excision of pilonidal sinus disease had the wound repaired using a parasacral perforator flap. Outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires. RESULTS There were ten minor complications including six minor wound edge dehiscences. There were two ischaemic complications, with one flap loss. There were 3 recurrences of pilonidal disease at a mean follow-up of 33 months, giving a 5-year recurrence free rate of 86%. Of the patients questioned, all would recommend the procedure to someone else despite 69% being dissatisfied with the cosmetic outcome. CONCLUSIONS This series indicates that the parasacral perforator flap technique is able to repair pilonidal sinus excision wounds successfully with minimal morbidity and a low recurrence rate at a mean of follow-up of 33 months. The study suggests that it may be a technique best reserved for recurrent cases of pilonidal sinus disease. Patients feel the procedure is successful despite reservations regarding the cosmetic outcome.

scholarly journals Minimally Invasive Fibrin Sealant Application in Pilonidal Sinus: A Comparative Study

2018 ◽  
Vol 119 (2-3) ◽  
pp. 107-112
Author(s):  
Mahmud Saedon ◽  
Andrew Chin ◽  
Maryam Alfa-Wali ◽  
Chun Kheng Khoo ◽  
Aarti Varma
Keyword(s):  
Pilonidal Sinus ◽  
Fibrin Sealant ◽  
Primary Closure ◽  
Sinus Tract ◽  
Pilonidal Sinus Disease ◽  
First Episode ◽  
Sinus Disease ◽  
Chi Squared ◽  
Ongoing Infection

The aim of this study was to compare the filling of the pilonidal sinus tract with fibrin sealant (FS) against tract excision and primary closure (PC) as the primary procedure. Details of all patients who underwent treatment for a symptomatic first episode of pilonidal sinus disease between January 2011 and December 2015 were prospectively recorded in a custom database. Patients underwent PC (n=17) or FS (n=17) according to patient preference. Prior surgical treatment and ongoing infection precluded entry. Patients were treated with antibiotics if presenting with infection. Outcomes measured were recurrence, further procedures, outpatient attendances and length of follow-up to resolution. 34 consecutive patients [FS vs. PC: male n=15 vs. 12 p=0.398; mean age 29 (SEM 12) vs. 30 (SEM 15) p=0.849] were included. Treated preoperative infections were similar FS (n=5) vs. PC (n=12) (p=0.038, chi-squared test). FS cohort had more sinuses FS median (range) 2 (1–4) vs. PC 1 (1–3) (p=0.046). Postoperative outcomes: recurrence rate FS (n=5) vs. PC (n=4) (p=0.629); infection rate FS (n=1) vs. PC (n=8) (p=0.045); total number of operations required FS 1 (1–2) vs. PC 1 (1–4) (p=0.19); total number of outpatient attendance FS 2 (1–7) vs. PC 3 (1–16) (p=0.629); follow-up FS 129 days ± 33 vs. PC 136 ± 51 (p=0.914). Fibrin sealant is not inferior to excision followed by primary closure.

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.

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