scholarly journals EFFECTIVENESS OF GLUTEUS MAXIMUS FASCIA PLASTY FLAP FOR CLOSURE OF WOUND IN SURGICAL TREATMENT OF PILONIDAL DISEASE

2018 ◽  
Vol 24 (5) ◽  
pp. 233-236
Author(s):  
Yury E. Kitsenko ◽  
D. D Shlyk ◽  
I. A Tulina ◽  
D. R Markaryan ◽  
P. V Tsarkov
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Operation Time ◽  
Gluteus Maximus ◽  
Long Term Results ◽  
Midline Closure ◽  
Fascia Flap

Aim: to compare short- and long-term results of primary midline closure and gluteus maximus fascia flap plasty after pilonidal sinus excision. Method: retrospective analysis included consecutive patients who had primary and recurrent pilonidal sinus excised. Patients with gluteus maximus fascia flap plasty formed 1st group, patients with primary midline closure formed 2nd group. Gluteus maximus fascia flap plasty technique: (i) separation in lateral directions of both gluteus maximus fascia from muscle and subcutaneous tissue; (ii) mobilised fascia flaps are brought together to midline and sutured; (iii) subcutaneous fat and skin sutured. Results: 60 patients operated in 2007-2016 were included: 28 in 1st group, 32 in 2nd group. Groups 1 and 2 didn’t differ in operation time (41.9±4.0 and 37.3±3.1 min, p=0.4), blood loss (6.9±0.5 and 8.3±1.6 ml, p=0.2), draining rate (7.1% and 12.5%, p=0.5), hospital stay (11.8±1.3 and 9.1±1.0 days, p=0.1), time to complete wound epithelialization (1.2±0.2 and 1.5±0.4 months, p=0.37). Mean follow-up was 20.7±3.2 and 53.8±6.5 months respectively. Recurrence rate was significantly lower in gluteus maximus fascia flap plasty group (3.6%) than in the 2nd group (21.9%, p=0.04). Conclusion: gluteus maximus fascia flap plasty after pilonidal sinus excision is feasible, doesn’t increase postoperative complications rate and leads to a lower recurrence rate compared to midline closure.

scholarly journals LASER ABLATION FOR PILONIDAL DISEASE

2020 ◽  
Vol 19 (2) ◽  
pp. 91-103
Author(s):  
D. A. Khubezov ◽  
R. V. Lukanin ◽  
A. R. Krotkov ◽  
A. Y. Ogoreltsev ◽  
P. V. Serebryansky ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Main Group ◽  
Cosmetic Result ◽  
Control Group ◽  
Primary Wound Closure

AIM: to evaluate short-term results of pilonidal disease treatment using different methods: the excision of pilonidal sinus and fistula with open wound healing, the primary closure of the wound and the laser ablation (2017-2019).PATIENTS AND METHODS: ninety patients with pilonidal disease without abscess were included in the comparative non-randomized study. The control group included 30 patients with excision and open wound healing. The first main group included 30 patients with the excision of pilonidal sinus and fistula with primary wound closure. The second main group included 30 patients with laser ablation of pilonidal sinus and fistula. The evaluation criteria included gender, age, BMI, number of previous procedures, operative time, hospital stay, postoperative pain intensity (VAS), cosmetic result (VAS), complication rate and recurrence rate.RESULTS: all three groups were homogeneous in gender, age, BMI. The control group showed no complications (р<0.0001) and no recurrence (р<0.0001) rate but had more intensive pain (mean 5.9 points; р<0.0001) and worse cosmetic result (mean 4.4 points; р<0.0001). The group with primary wound closure (1st main group) had the highest complication rate (23.4%; р=0.004) and recurrence rate (16.7%; р=0.02). The group with laser ablation had significantly shorter hospital stay (1.1 days; р<0.0001), good cosmetic result (mean 8.9 points; р<0.0001) and less postoperative pain (1.4 points; р<0.0001) with low recurrence rate (3.3%; p=0.32).CONCLUSION: the laser ablation of pilonidal sinus and fistula provides less postoperative pain intensity and low recurrence rate, better cosmetic result and short hospital stay. It can be used for outpatient treatment.

scholarly journals A COMPARATIVE CLINICAL STUDY OF ‘CHEDANA KARMA & KSHARSUTRA (SETON) KARMA’ (GUGGULU BASED) IN THE MANAGEMENT OF SHALYAJ NADI VRANA(SINUS) W.S.R. TO PILONIDAL SINUS (ASSOCIATED WITH ROPAN LEPA)

2021 ◽  
Vol 9 (2) ◽  
pp. 327-334
Author(s):  
Syed Abdul Wahid ◽  
Arvind Gajbhiye
Keyword(s):  
Clinical Study ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Common Disease ◽  
Natal Cleft ◽  
Surgical Interventions ◽  
Comparative Clinical Study ◽  
Ayurvedic Treatment ◽  
Treatment Aspect

A Pilonidal Sinus is a common disease of the natal cleft. Pilonidal Sinus is a track which contains hairs. The incidence of the disease is calculated to be 26 per 100,000 people. Pilonidal disease has a male pre-dominance with a ratio of 3:1. There are several methods to treat pilonidal sinus, but the recurrence rate is more in modern surgical interventions. According to Ayurveda it can be correlated to Salyajanya Nadi Vrana (pilonidal sinus), a type of Nadi Vrana (sinus). Whose etiopathology is described in Nidanasthana and treatment aspect in Chikitsasthana of Susrutha Samhita. Susrutha mentioned the ap-plication of Kshara (caustic alkali) and Ksharsutra (Seton) (Seton) in the management of Nadi Vrana (si-nus). Studies show that by Ayurvedic treatment, it helps to reduce recurrence rate, even though Nadi Vrana (sinus) is said to be Kricchrasadhya (difficult to cure). Hence successful management of this disease de-pends on the knowledge of pathogenesis, patient’s presentation and knowledge on treatment aspects. In this Clinical study, effect of Chedana karma & Ksharsutra (Seton) karma’ (Guggulu based) in the management of Salyajanya Nadi Vrana (pilonidal sinus) w.s.r. To pilonidal sinus (associated with ropan lepa) is seen and conclusion in drawn.

scholarly journals Outcome of Excision with Primary Midline Closure for Sacrococcygeal Pilonidal Sinus Disease

2020 ◽  
pp. 19-26
Author(s):  
Bahzad Waso Hamad
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Chronic Inflammatory Disease ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Public And Private ◽  
Female Ratio ◽  
Sinus Disease ◽  
Postoperative Wound ◽  
Midline Closure

Sacrococcygeal Pilonidal sinus disease is common chronic inflammatory disease affecting chiefly young adult male . It cause much discomfort and morbidity and affect negatively the quality of life of patients. There are various techniques of surgical treatment for the chronic sinuses but still there is no gold standard one. The aim of this study to report our experience with excision and midline closure technique of chronic Sacrococcygeal Pilonidal sinus disease and to identify the outcome of the procedure for postoperative wound complications and recurrence rate. This is a retrospective study with telephone contact and review of 36 patients operated for Sacrococcygeal pilonidal sinus disease from January 2011 through January 2016 under care of one consultant surgeon (the Author) in Public and Private Hospitals in Rania, Sulaimani, Iraq. Inclusion criteria was all patients with chronic midline located sinuses without evidence of acute inflammation. Exclusion criteria was all infected ,off midline located sinuses and recurrent sinuses. Elliptical Excision of the sinuses with primary midline closure over a vacuum drainage performed. End point of this study was rate of wound complications and recurrence of sinus. Thirty six patients with median age 22 years (range 14-40) with 24/12 male /female ratio. Median follow up was 24 months (12 - 66 months), the recurrence occurred in 3/36 ( 8.3%) patients at a median of 12 months (range 5 - 48), failure of treatment in 5/36 (13.9%) patients, and postoperative wound complications was seen in 5/36 ( 13.9%) patients. In the conclusion, excision and primary midline closure is simple, effective and preferable procedure for management of uncomplicated Sacrococcygeal pilonidal sinus disease associated with early wound healing and low rate of postoperative wound complications and recurrence rate.

Sinus pilonidalis fisztuloszkópos kezelése gyermekekben

2021 ◽  
Vol 162 (43) ◽  
pp. 1740-1743
Author(s):  
Balázs Fadgyas ◽  
Márk Langer ◽  
Zoltán Ringwald
Keyword(s):  
Wound Healing ◽  
Adverse Events ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Healing Time ◽  
Sinus Pilonidalis ◽  
Everyday Activity ◽  
Wound Healing Time

Összefoglaló. Bevezetés: A sinus pilonidalis nehezen kezelhető, sok szövődménnyel és recidívával járó betegség. A legtöbb műtéti eljárás többnapos kórházi kezelést, munkából vagy iskolából való hiányzást követel. Célkitűzés: Munkánk célja, hogy a PEPSiT- (pediatric endoscopic pilonidal sinus treatment) műtétek eredményességét vizsgálja. Módszer: Intézetünkben 2019–2020-ban PEPSiT-műtéten átesett, 18 év alatti betegeket válogattunk be a vizsgálatba. Kizártuk a cisztoszkóppal operált és kontrollra nem jelentkező betegeket. A szövődmények, recidívák számát, a kórházi tartózkodás hosszát, a sebgyógyulás és a hétköznapi aktivitáshoz való visszatérés idejét vizsgáltuk. Eredmények: Betegeink többsége fiú (24 fiú, 4 lány), átlagéletkoruk 15,6 év volt. 28 betegen 31 PEPSiT-beavatkozást végeztünk (3 re-PEPSiT), 6 recidíva, 1 sebgennyedés alakult ki. A betegek egy része egynapos ellátás keretében, míg a többség egy éjszaka bentfekvés után tért haza (1,74 nap ápolási idő). A hétköznapi aktivitáshoz 1,37 nap után tértek vissza, a gyógyulási idő 5,9 hét volt átlagosan. Megbeszélés: A PEPSiT-beavatkozás minimálisan invazív lehetőség, igen rövid kórházi tartózkodással. A betegek hamar térnek vissza a szokott aktivitásukhoz, a korábbi sipolyon kívül újabb műtéti seb nem alakul ki. A recidívaarány hasonló az egyéb technikákéhoz. Következtetés: A PEPSiT-beavatkozás jól alkalmazható, a recidívaarány csökkentése fontos. Orv Hetil. 2021; 162(43): 1740–1743. Summary. Introduction: The treatment of pilonidal disease is often challenging, due to frequent recurrences and adverse events. Most operative treatments require a lengthy hospital stay, and absence from school or work. Objective: We aimed towards assessing the effectivity of PEPSiT (pediatric endoscopic pilonidal sinus treatment). Method: In this study, we included patients subjected to PEPSiT from 2019 to 2020 between ages 0–18 years. Patients operated via cystoscope and patients who did not attend follow-up examinations were excluded. Adverse events, recurrences, length of hospital stay, wound healing time and return to everyday activity were assessed. Results: The majority of our patients were male (24 male, 4 female), the mean age was 15.6 years. 31 PEPSiT operations were recorded on 28 patients (3 were redo surgeries). 6 recurrences and 1 wound suppuration were documented. Some patients were treated within the confines of one-day surgery, while most of them stayed one night (mean length of stay was 1.74 days). Return to everyday activity was an average 1.37 days, and mean wound healing time was 5.9 weeks. Discussion: PEPSiT is a minimally invasive operative approach with a very short hospital stay. Patients return to everyday activity faster. New operative scarring does not happen apart from the preexisting fistula opening. Recurrence rate is similar to that of other treatment techniques. Conclusion: PEPSiT technique is applicable, however, reduction of the recurrence rate is important. Orv Hetil. 2021; 162(43): 1740–1743.

scholarly journals WIDE EXCISION AND RHOMBOID FLAP RECONSTRUCTION FOR TREATMENT OF COMPLEX PILONIDAL DISEASE. CASE SERIES AND REVIEW OF LITERATURE.

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Thomas W Athisayaraj ◽  
Boby Sebastian ◽  
Justin Alberts
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Case Series ◽  
Wide Excision ◽  
Pilonidal Sinus Disease ◽  
Flap Reconstruction ◽  
Previous Surgery ◽  
Sinus Disease ◽  
Rhomboid Flap

Introduction: Pilonidal disease a chronic inflammatory disorder affecting the sacrococcygeal region with superimposed infection. This problem can present with acute abscess or chronic discharging sinus and often difficult to treat due to high incidence of recurrence. We are presenting our case series of wide excision and rhomboid flap reconstruction of complex pilonidal sinus disease. Methods: This is a retrospective review of our series of patients who have had rhomboid flap reconstruction done in colorectal surgery department for complex pilonidal sinus disease. The time period between   is 2003 to 2017. The review was conducted from our electronic data base in our hospital. Results: We had 50 patients in total. 30out of 50 have had previous surgery for pilonidal sinus disease. Five patients developed recurrence (10% recurrence rate). 4 out of 5 patients who had recurrence were smokers.4 out of 5 patients with recurrence had previous surgery for pilonidal disease. The median age of the patients was 28.The age ranged from 16 to 49 years. The median length of stay is about 4 days Conclusion: In conclusion Rhomboid flap reconstruction is a viable operation for complex pilonidal disease. The long term results are good. It can be safely performed by a general /colorectal surgeon with good results. It is a good option for complex pilonidal sinus and recurrent disease following multiple previous operations. The recurrence rate seems to be higher in smokers and in patients who had previous surgery in natal cleft.

scholarly journals Minimally invasive pilonidal sinus treatment: A narrative review

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 532-536 ◽  
Author(s):  
Nunzio Velotti ◽  
Michele Manigrasso ◽  
Katia Di Lauro ◽  
Enrico Araimo ◽  
Federica Calculli ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Subcutaneous Tissue ◽  
Minimal Invasive ◽  
Endoscopic Approach ◽  
Pilonidal Sinus Disease ◽  
Surgical Approaches ◽  
Early Return ◽  
Cutaneous Tissue ◽  
High Satisfaction Rate

AbstractThe management of chronic pilonidal disease remains controversial, but recently, new minimal invasive approaches have been proposed. Whereas in the conventional surgical treatment an elliptical wedge of skin and subcutaneous tissue is created to remove the sinus and its lateral tracks, the basis for our new treatment is to create a minimal elliptical wedge of the subcutaneous tissue, including all the inflamed tissue and debris while leaving the overlying skin intact.The mechanism of an endoscopic approach relies on use of the endoscope without cutaneous tissue damage. Advantages include shorter operative time and time to discharge, which impact resource management in both primary and secondary care: patients undergoing endoscopic technique have a high satisfaction rate, probably due to the low level of postoperative pain and early return to work and daily activities. However, it is mandatory that further studies would analyze surgical approaches to pilonidal sinus disease (PSD) with a consistent and adequate follow-up of at least 5 years. Both sinusectomy and endoscopic approach to PSD were found to be safe and effective compared with conventional techniques. Publishedresults of studies of newer approaches have demonstrated a low short-term complication rate, comparable to conventional surgery results.

A Review on Salyajanya Nadi Vrana (pilonidal sinus) with clinical approach

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Rajasree G. ◽  
Anita K. Patel
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Common Disease ◽  
Clinical Approach ◽  
Natal Cleft ◽  
Surgical Interventions ◽  
Male Predominance ◽  
Ayurvedic Treatment ◽  
Treatment Aspect

A Pilonidal Sinus is a common disease of the natal cleft. Pilonidal Sinus is a track which containing hairs. The incidence of the disease is calculated to be 26 per 100,000 people. Pilonidal disease has a male predominance with a ratio of 3:1. There are several methods to treat pilonidal sinus, but the recurrence rate is more in modern surgical interventions. According to Ayurveda it can be correlated to Salyajanya Nadi Vrana (pilonidal sinus), a type of Nadi Vrana (sinus). Whose etiopathology is described in Nidanasthana and treatment aspect in Chikitsasthana of Susrutha Samhita. Susrutha mentioned the application of Kshara (caustic alkali) and Ksharasutra (Seton) in the management of Nadivrana. Studies shows that by Ayurvedic treatment, it helps to reduce recurrence rate, even though Nadivrana is said to be Kricchrasadhya (difficult to cure). Hence sucessful management of this disease depends on the knowledge of pathogenesis, patients presentation and knowledge on treatment aspects.

PILONIDAL DISEASE: CHANGES IN UNDERSTANDING OF ETIOLOGY, PATHOGENESIS AND APPROACH TO TREATMENT

2019 ◽  
Vol 72 (8) ◽  
pp. 1559-1565
Author(s):  
Viktor Konoplitskyi ◽  
Ruslan Shavliuk ◽  
Dmytro Dmytriiev ◽  
Kostiantyn Dmytriiev ◽  
Oleksii Kyrychenko ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pilonidal Sinus ◽  
Randomized Clinical Trials ◽  
Web Of Science ◽  
Surgical Intervention ◽  
Pilonidal Disease ◽  
Treatment Methods ◽  
Principles Of Treatment ◽  
Selection Of

Data from Web of Science, SCOPUS, Pub Med, Medline, E-library, and other sources was used in writing this article. The main focus was directed towards literature written in English. The selection of literature was based on such concepts as: etiopathogenesis, historical principles of treatment, methods of surgical and non-surgical intervention. Data from metanalysis publications and randomized clinical trials pertaining to the treatment of the pilonidal sinus at various stages of its formation was used, as well.

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