scholarly journals Rethinking the causes of pilonidal sinus disease: a matched cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dietrich Doll ◽  
Imke Brengelmann ◽  
Patrick Schober ◽  
Andreas Ommer ◽  
Friederike Bosche ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Risk Factor ◽  
Cohort Study ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Matched Pairs ◽  
Matched Cohort ◽  
Sinus Disease ◽  
Sweat Collection ◽  
Pilocarpine Iontophoresis

AbstractOur understanding of pilonidal sinus disease (PSD) is based on a paper published 29 years ago by Karydakis. Since then, surgeons have been taught that hair more easily penetrates wet skin, leading to the assumption that sweating promotes PSD. This postulate, however, has never been proven. Thus we used pilocarpine iontophoresis to assess sweating in the glabella sacralis. 100 patients treated for PSD and 100 controls were matched for sex, age and body mass index (BMI). Pilocarpine iontophoresis was performed for 5 min, followed by 15 min of sweat collection. PSD patients sweated less than their matched pairs (18.4 ± 1.6 µl vs. 24.2 ± 2.1 µl, p = 0.03). Men sweated more than women (22.2 ± 1.2 µl vs. 15.0 ± 1.0 µl in non-PSD patients (p < 0.0001) and 20.0 ± 1.9 µl vs. 11.9 ± 2.0 µl in PSD patients (p = 0.051)). And regular exercisers sweated more than non-exercisers (29.1 ± 2.9 µl vs. 18.5 ± 1.6 µl, p = 0.0006 for men and 20.7 ± 2.3 µl vs. 11.4 ± 1.4 µl, p = 0.0005 for women). PSD patients sweat less than matched controls. Thus sweating may have a protective effect in PSD rather than being a risk factor.

High Body Mass Index as a Possible Risk Factor for Pilonidal Sinus Disease in Adolescents

2005 ◽  
Vol 29 (4) ◽  
pp. 469-471 ◽  
Author(s):  
İrfan Serdar Arda ◽  
L. Hakan Güney ◽  
Şinasi Sevmiş ◽  
Akgün Hiçsönmez
Keyword(s):  
Body Mass Index ◽  
Risk Factor ◽  
Body Mass ◽  
Pilonidal Sinus ◽  
High Body Mass Index ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
High Body

scholarly journals Predisposition and risk factor rates for pilonidal sinus disease

2016 ◽  
Vol 39 (2) ◽  
pp. 120-121 ◽  
Author(s):  
Kazim Duman ◽  
Ali Harlak ◽  
Oner Mentes ◽  
Ali K. Coskun
Keyword(s):  
Risk Factor ◽  
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 Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany

2021 ◽  
Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Jan Gödeke
Keyword(s):  
Pilonidal Sinus ◽  
Regional Variation ◽  
Disease Incidence ◽  
Age Groups ◽  
Pilonidal Sinus Disease ◽  
National Guidelines ◽  
Reconstructive Procedures ◽  
Sinus Disease ◽  
The Mean ◽  
Almost All

Abstract Purpose Collective evidence from single-centre studies suggests an increasing incidence of pilonidal sinus disease in the last decades, but population-based data is scarce. Methods We analysed administrative case–based principal diagnoses of pilonidal sinus disease and its surgical therapy between 2005 and 2017 in inpatients. Changes were addressed via linear regression. Results The mean rate of inpatient episodes of pilonidal sinus disease per 100,000 men increased from 43 in 2005 to 56 in 2017. In females, the mean rate of inpatient episodes per 100,000 women rose from 14 in 2005 to 18 in 2017. In the whole population, for every case per 100,000 females, there were 3.1 cases per 100,000 males, but the numbers were highly variable between the age groups. There was considerable regional variation within Germany. Rates of inpatient episodes of pilonidal sinus disease were increasing in almost all age groups and both sexes by almost a third. Surgery was dominated by excision of pilonidal sinus without reconstructive procedures, such as flaps, whose share was around 13% of all procedures, despite recommendations of the national guidelines to prefer flap procedures. Conclusion Rates of inpatient episodes of pilonidal sinus disease in Germany rose across almost all age groups and both sexes with relevant regional variation. The underlying causative factors are unknown. Thus, patient-centred research is necessary to explore them. This should also take cases into account that are solely treated office-based in order to obtain a full-spectrum view of pilonidal sinus disease incidence rates.

Intermammary Hidradenitis Suppurativa: Considerations on a Unique Presentation

2021 ◽  
pp. 1-4
Author(s):  
Ana Luísa João ◽  
Nélia Cunha ◽  
Joana Cabete
Keyword(s):  
Surgical Approach ◽  
Inflammatory Disease ◽  
Pilonidal Sinus ◽  
Hidradenitis Suppurativa ◽  
Chronic Inflammatory Disease ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Case Presentation ◽  
Overweight Women

Introduction: Hidradenitis suppurativa (HS) is a potentially disabling chronic inflammatory disease. The intermammary location, not clearly specified in the usual phenotypic classifications, entails significant functional and cosmetic compromise. Case Presentation: Eleven cases of predominantly intermammary disease with multiple fistulization and disfiguring scarring were observed at our Department between January 2016 and March 2020. They were young (mean age = 22 years) obese or overweight women, in which the medical-surgical approach has led to variable results. Discussion/Conclusion: Intermammary HS possibly represents a unique phenotypic presentation, likely to be fistulizing and severe. We believe that anatomo-functional considerations, which can be paralleled to pilonidal sinus disease, contribute to its pathophysiology and striking appearance, and further emphasize the importance of multidisciplinary endeavor to reduce the morbidity associated with this seemingly overlooked location.

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