An Experience On Cyrstallized Phenol Treatment For Pilonidal Sinus In The Children During Covid-19 Pandemic Period

The objective of the study was to compare the results of the patients treated with crystallized phenol treatment (CPT) or simple primary closure (SPC) for pilonidal sinus disease (PSD). For PSD treatment, both SPC and CPT have the advantages of rapid recovery, minimal pain, and short hospital stay. Even though these two techniques can be used interchangeably in uncomplicated cases, there is not enough evidence about which method is superior. A total of 102 patients who underwent CPT (n = 57) and SPC (n = 45) for uncomplicated PSD were included in the study. In all of the cases, data were recorded and compared between CPT and SPC groups, including age, gender, duration of the symptoms, hospital stay, complications, healing time, and recurrence. The mean age was 25.6 years and the male-to-female ratio was 93:9. The SPC and CPT groups were similar in terms of age, gender, duration of symptoms, complications, and healing time. The CPT group did not require hospitalization or anesthetic procedure in addition to local anesthesia, but the SPC group required a median of 1 day (range, 1–3 days) of hospitalization, and 3 patients (6.7%) needed spinal anesthesia. During a median of 27.5 months' follow-up, the recurrence rate in the CPT group (6 patients; 10.5%) was lower than in the SPC group (13 patients; 28.9%). Both hospital stay and recurrence rates were better in the CPT group. Healing time and complication rates were similar in both methods. Based on these results, we suggest that CPT should be preferred to SPC in uncomplicated cases.

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Does hair removal necessary after crystallized phenol treatment in pilonidal disease?

Medical Principles and Practice ◽

10.1159/000516903 ◽

2021 ◽

Author(s):

Süleyman Kargın ◽

Osman Doğru ◽

Ersin Turan

Keyword(s):

Pilonidal Sinus ◽

Pilonidal Disease ◽

Area Under The Curve ◽

Hair Removal ◽

Pilonidal Sinus Disease ◽

Sinus Disease ◽

Removal Time ◽

Application Data ◽

Phenol Treatment ◽

Crystallized Phenol

Objective: The most important cause of post-treatment recurrence in the pilonidal sinus is the re-entry of hair into the skin. The study aimed to investigate the effect of hair removal and its duration on the prevention of recurrences after crystallized phenol treatment. Subject and Methods: The patients with pilonidal sinus disease who were treated with crystallized phenol treatment were evaluated. Hair in the sacrococcygeal area were removed with depilatory cream before every crystallized phenol procedure, during the treatment, and after treatment once a month for six years. Of 1016 patients, 735 were contacted by telephone or e-mail regarding the frequency of sacrococcygeal hair removal and recurrence. Demographic and sinus features and crystallized phenol application data of patients treated with crystallized phenol for pilonidal sinus disease, as well as recurrences were retrospectively assessed. Results: The mean follow-up time was 46.23 ± 33 (range, 11–240) months, with 139 (18.9%) patients experiencing recurrence. Patients who underwent hair removal experienced significantly less recurrence than those who did not (p = 0.003, odds ratio (OR): 0.54 [0.36–0.82]). The OR of recurrence decreased by 0.8% every month as the hair removal time increased (OR = 0.992, 95% CI = 0.985-1.000, p = 0.049). The cut-off value for sensitivity was 0.636, specificity 0.466, and area under the curve 0.562 in hair removal procedures that lasted for over 30 months. Conclusion: Regular hair removal during and at least 30 months after crystallized phenol treatment reduced recurrences in patients with pilonidal sinus disease.

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Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽

10.1024/1023-9332.8.6.255 ◽

2002 ◽

Vol 8 (6) ◽

pp. 255-258 ◽

Cited By ~ 28

Author(s):

Perruchoud ◽

Vuilleumier ◽

Givel

Keyword(s):

Hospital Stay ◽

Pilonidal Sinus ◽

Primary Closure ◽

Average Length ◽

Length Of Hospital Stay ◽

Healing Time ◽

Incision And Drainage ◽

The Mean ◽

Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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Basal cell epithelioma arising in a pilonidal sinus

Archives of Dermatology ◽

10.1001/archderm.98.3.277 ◽

1968 ◽

Vol 98 (3) ◽

pp. 277-281 ◽

Cited By ~ 2

Author(s):

Z. Rubin

Keyword(s):

Basal Cell ◽

Pilonidal Sinus ◽

Basal Cell Epithelioma

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Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44071 ◽

2020 ◽

Vol 22 (2) ◽

pp. 89-94

Author(s):

Nasir Uddin Mahmud ◽

ABM Khurshid Alam ◽

Mohammad Altaf Hossain Chawdhury ◽

Mohammad Abul Khair

Keyword(s):

Pilonidal Sinus ◽

Skin Barrier ◽

Limberg Flap ◽

College Hospital ◽

Medical College ◽

Flap Technique ◽

Unpleasant Smell ◽

Lower Morbidity ◽

Computer Operator

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance. Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017. Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period. Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity. Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

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Pilonidal sinus disease: Karydakis flap procedure in our patients

Perspectives in Surgery ◽

10.33699/pis.2020.99.8.350-355 ◽

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.

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Umbilical Pilonidal Sinus- A Rare Clinical Occurence

PARIPEX-INDIAN JOURNAL OF RESEARCH ◽

10.15373/22501991/feb2014/85 ◽

2012 ◽

Vol 3 (2) ◽

pp. 249-250

Author(s):

Uroos Fatima ◽

◽

Yogesh Kumar Yadav

Keyword(s):

Pilonidal Sinus

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