scholarly journals SP7.1.12 Could surgery under local anaesthetic be the default for Pilonidal Sinus Disease? A systematic review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kiren Ali ◽  
Ahmed Tahir ◽  
Siobhan Chien ◽  
Olusegun Komolafe
Keyword(s):  
Systematic Review ◽  
Local Anaesthetic ◽  
Pilonidal Sinus ◽  
Local Anaesthesia ◽  
Economic Benefits ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Published Evidence ◽  
Early Return ◽  
Significant Difference

Abstract Aims Pilonidal sinus disease (PSD) is a significant cause of morbidity. The purpose of this systematic review and meta-analysis is to determine the totality of evidence regarding the effectiveness of Local Anaesthesia (LA) when compared to spinal or general anaesthesia in individuals undergoing definitive surgery for PSD. Methods A systematic review of literature was conducted. Studies included randomized controlled trials comparing LA with other anesthetics and non-randomized studies focusing on ambulatory procedure of excising pilonidal sinus aiming wound closure, all performed under local anesthetics. We used Cochrane risk of bias tool. The statistical analysis was done using Revman and Excel. Results Four original RCTs and 10 observational studies were included, with a total of 1801 patients. There was no significant difference in operative time between the groups Patients in the local anaesthetic group experienced less pain than those in other group, lower rates of anaesthetic related complications, early return to work and increased satisfaction. However, the mode of anaesthesia used had no relation with recurrence. Conclusion Our findings support the use of LA in adult patients undergoing definitive surgical treatment for PSD. We aggregate the published evidence to demonstrate clear benefits clinically, patients’ preference, and economic benefits. Patient selection, and adequate dose of local anaesthetic, is the key. In the context of the current COVID—19 pandemic, novel care pathways need to be developed in all medical fields, and we would propose that surgery for Pilonidal Sinus Disease under local anaesthesia should now be the default.

scholarly journals Management of pilonidal sinus disease with Limberg flap: our experience

2020 ◽  
Vol 7 (5) ◽  
pp. 1575
Author(s):  
Mahavir Singh ◽  
Saish Dalal ◽  
Baleshwar . ◽  
Sethu Raman
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Pilonidal Sinus Disease ◽  
Common Disease ◽  
Main Concern ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Minimal Scarring ◽  
Early Return

Background: Pilonidal sinus disease is a common disease of young adults. The management of the sacrococcygeal pilonidal sinus varies from conservative measures to various surgical procedures. The main concern for the treatment to the patient is the recurrence. Although several methods have been described all have been associated with high recurrence rates. This study was carried out to evaluate the advantages, results of rhomboid excision and limberg flap reconstruction in the management of pilonidal sinus disease.Methods: This prospective study was conducted in General Surgery department of a tertiary care centre of Haryana. It includes 29 patients who were treated for pilonidal sinus disease by Limberg flap surgery from January 2015 to January 2019.  Results: All patients were successfully treated with minimal postoperative discomfort. Only two patients developed seroma which was managed conservatively and in two patients there was slight flap tip necrosis which was also managed conservatively. Rest all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no recurrence so far.Conclusions:Limberg flap is very effective treatment for pilonidal disease. It has many advantages as it is easy to perform and design, and it flattens the natal cleft with large vascularized pedicle, sutured without tension. This in turn maintains good hygiene, reducing the friction, preventing maceration, and avoiding scar in the midline. The technique is easy to perform in quick time, useful in both primary and recurrent diseases, with very low complication and recurrence rate. Other advantages are quick healing time, short hospital stay, and early return to daily life.  

scholarly journals Gender‐specific prevalence of pilonidal sinus disease over time: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Markus M. Luedi ◽  
Patrick Schober ◽  
Verena K. Stauffer ◽  
Maja Diekmann ◽  
Lukas Andereggen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pilonidal Sinus ◽  
Meta Analysis ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Gender Specific ◽  
Over Time

Limberg flap in management of pilonidal sinus disease: systematic review and a local experience

2018 ◽  
Vol 118 (2) ◽  
pp. 78-84 ◽  
Author(s):  
Mohamed Boshnaq ◽  
Yih Chyn Phan ◽  
Iana Martini ◽  
Mohanraj Harilingam ◽  
Mansoor Akhtar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Local Experience

scholarly journals Comparison of different surgical techniques of sacrococcygeal pilonidal sinus disease

2021 ◽  
Vol 38 (3) ◽  
pp. 283-287
Author(s):  
Sercan BÜYÜKAKINCAK ◽  
İsmail Alper TARIM ◽  
Banu KARAPOLAT ◽  
Gökay ATEŞ
Keyword(s):  
Pilonidal Sinus ◽  
Surgical Techniques ◽  
Sensory Loss ◽  
Pilonidal Sinus Disease ◽  
Primary Group ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Rotation Flap ◽  
Significant Difference ◽  
Length Of Hospitalization

Pilonidal sinus, especially in young males, is one of the most common diseases of the sacrococcygeal region. Although many surgical techniques have been described for pilonidal sinus disease (PSD), high recurrence rates and patient satisfaction are still controversial with regard to the ideal treatment modality. In this study, we aimed to compare the complications in Primary excision, Limberg flap, elliptical rotation flap and karydakis techniques used in patients with pilonidal sinus disease. The patients who were diagnosed with Pilonidal sinus and underwent surgery between January 2012 and January 2017 were retrospectively analysed from our hospital database. Patients in whom the Primary repair, Limberg flap, elliptical rotation flap and karydakis flap repair performed were divided into four groups. The groups were compared in terms of their demographic characteristics, length of hospitalization, seroma formation, surgical site infections, wound dehiscence, flap necrosis, sensory loss and recurrence. There were 107 patients in the primary group, 70 in the Limberg flap group, 72 in the elliptical rotation flap group and 45 in the karydakis flap group. There was a statistically significant difference between the groups in terms of the length of hospitalization (p < 0.001). The maximum length of hospitalization period was observed in the Limberg group and was 2.06 ± 0.95 days. The minimum duration of hospitalization was 1.00 ± 0.00 days in the karydakis group. Wound site infection was observed mostly in the primary group with 15% frequency, whereas this higher ratio was significant when compared with Elliptical Rotation flap and Karydakis flap groups (p = 0.010, 0.024 respectively). There was no statistically significant difference between the groups in terms of wound dehiscence, flap necrosis, sensory loss and recurrence. There is no consensus on the ideal surgical technique selection for PSD. Our study revealed that wound infection is common in patients undergoing Primary repair and that there is a difference in terms of length of hospitalization for different techniques. We expect the factors we investigate to be a guide for the surgeons.

scholarly journals Surgical interventions for the treatment of sacrococcygeal pilonidal sinus disease in children: A systematic review and meta-analysis

2019 ◽  
Vol 54 (11) ◽  
pp. 2222-2233 ◽  
Author(s):  
Edward John Oliver Hardy ◽  
Philip J Herrod ◽  
Brett Doleman ◽  
Hannah G Phillips ◽  
Reesha Ranat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pilonidal Sinus ◽  
Meta Analysis ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Surgical Interventions

scholarly journals Assessment of the effect of platelet rich plasma on the healing of operated sacrococcygeal pilonidal sinus by lay-open technique: a randomized clinical trial

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohamed M. Gohar ◽  
Reda F. Ali ◽  
Khaled A. Ismail ◽  
Taha A. Ismail ◽  
Nahla A. Nosair
Keyword(s):  
Pilonidal Sinus ◽  
Platelet Rich Plasma ◽  
Trial Registration ◽  
University Hospital ◽  
Pilonidal Sinus Disease ◽  
Open Method ◽  
Early Return ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Sacrococcygeal pilonidal sinus disease (PSD) is an infection of the skin and subcutaneous tissue at the upper part of the natal cleft of the buttocks. Excision and healing by granulation “lay-open” method is still more preferable than other methods of midline closure or using flaps but the healing time is lengthy. The present study was performed to assess the healing promotion effect of platelet-rich plasma (PRP) on the pilonidal sinus wounds treated by the lay-open method. Methods One hundred patients suffering from PSD were randomly divided into two groups, they were treated by the lay-open method, at General surgery department, Kafr El-Sheik University hospital, Egypt, during the period from December 2018 to December 2019. Group (A) was adopted the regular dressing postoperatively, while group (B) was treated with PRP injection into the wound at 4 and 12 postoperative days. Results Accelerated rate of wound healing was detected in group (B) in day 10, with a significant difference detected in days 15, 20, 25 and 30 postoperative, with a mean time of complete healing 45 ± 2.6 days in group B, while it was 57 ± 2.4 days in group A with a p-value of 0.001 which indicates considerable effect in the treated group. Conclusions PRP injection is an effective new technique in accelerating the healing of pilonidal wound after surgery, with a significant decrease in post-operative pain, complications and an early return to work. Trial registration retrospectively registered. Trial registration number: 12/35/1016 issued on December 2018 from the Institution Review Board at Kafr El Sheikh University. ClinicalTrials.gov identifier: NCT04430413

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