scholarly journals S-Shaped Wide Excision with Primary Closure for Extensive Chronic Pilonidal Sinus Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kerem Karaman ◽  
Safak Ozturk ◽  
Cem Tugmen ◽  
Eyup Kebapcı ◽  
Sait Murat Dogan ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wide Excision ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Postoperative Course ◽  
Large Patient ◽  
One Year ◽  
Disease Free

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years.Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient’s postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups.Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.

scholarly journals Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence

2012 ◽  
Vol 97 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Akin Onder ◽  
Sadullah Girgin ◽  
Murat Kapan ◽  
Mehmet Toker ◽  
Zulfu Arikanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Disease Risk ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Faculty Department ◽  
Closure Method

Abstract The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P  =  0.039). Regarding recurrence, family tendency (P  =  0.011), sinus number (P  =  0.005), cavity diameter (P  =  0.002), and primary closure (P  =  0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.

scholarly journals PILONIDAL SINUS DISEASE: COMPARISON OF EXCISION AND PRIMARY CLOSURE VERSES EXCISION AND HEALING BY SECONDARY INTENTION

1969 ◽  
Vol 2 (1) ◽  
pp. 134-137
Author(s):  
Mohammad Hussain ◽  
Manzoor Ali ◽  
S.M.Naeem ◽  
Nisar Ali ◽  
Muhammad Ismail
Keyword(s):  
Local Excision ◽  
Pilonidal Sinus ◽  
Wide Local Excision ◽  
Primary Closure ◽  
Health Concern ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Secondary Intention ◽  
Group A ◽  
Group B

Introduction: Sacrococcygeal pilonidal disease is a serious health concern because of its associatedcomplications and recurrence. Pilonidal sinus disease is presented with symptoms ranging fromasymptomatic pits to painful draining lesions that are predominantly located in the sacrococcygeal region. Itis characterized by multiple subcutaneous sinuses, containing hairs. The exact etiology of the disease is notknown. Various treatment options are available. The choice of a particular surgical approach depends on thesurgeon's familiarity with the procedure and perceived results. The present study was aimed to compare twotreatment regimens i.e.excision and primary closure verses excision and healing by secondary intention.Patients and methods: The study was conducted in the department of surgery, Saidu Teaching HospitalSaidu Sharif Swat. Forty nine (49) human subjects with informed consent were included in the study.Patients were divided in two groups, depending on their preference and acceptance of the procedure.Patients in group A under went excision of the tract with primary closure of the defect by primary simpleclosure, Rhomboid Limberg flap or by Karydakis procedure. Patients in group B were those in whom sinustracts were excised and wound was left open for healing by secondary intention.Results: Out of the total 49 patients 3 (6.122%) were female. Mean age was 26 years (range 18-40years).Group A comprised of 24 patients in whom wide local excision was performed and wound was closedprimarily while Group B comprised of 25 patients who underwent wide local excision and wound was leftopen for healing by secondary intention. Mean hospital stay of patients in group B was significantly longerthan group A (p=0.002). The mean time for complete healing of the wound after primary closure wasmarkedly shorter.mConclusion: Primary closure of the wound after excision of the sinus tract is preferable over simple excisionand healing by secondary intention.Key words; Pilonidal sinus, primary closure, simple excision.

Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate

2010 ◽  
Vol 180 (1) ◽  
pp. 173-176 ◽  
Author(s):  
S. N. S. Gilani ◽  
H. Furlong ◽  
K. Reichardt ◽  
A. O. Nasr ◽  
G. Theophilou ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease

scholarly journals Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus disease in the pediatric population

2018 ◽  
Vol 53 (10) ◽  
pp. 2003-2007 ◽  
Author(s):  
Joana Barbosa Sequeira ◽  
Ana Coelho ◽  
Ana Sofia Marinho ◽  
Berta Bonet ◽  
Fátima Carvalho ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pediatric Population ◽  
Pilonidal Sinus Disease ◽  
Total Excision ◽  
Sinus Disease

Management of Pilonidal Sinus Disease With Oblique Excision and Primary Closure: Results of 493 Patients

2006 ◽  
Vol 49 (1) ◽  
pp. 104-108 ◽  
Author(s):  
Oner Mentes ◽  
Mahir Bagci ◽  
Turker Bilgin ◽  
Ibrahim Coskun ◽  
Omer Ozgul ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
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 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.

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