Management of Pilonidal Sinus (Nadi Vrana) with Palasha Kshara Sutra prepared in Arka Ksheera - A Case Study

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Leena Naik ◽  
Ganapathi Rao ◽  
Ashok Naikar ◽  
Jyothi Rajole
Keyword(s):  
Minimally Invasive ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Risk Of Recurrence ◽  
Young Males ◽  
Chronic Disorder ◽  
Sacrococcygeal Region ◽  
Surgical Methods

Pionidal Sinus is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Different surgical methods have been described for this disorder. The most commonly used are excision and primary closure and excision with reconstructive flap. However the risk of recurrence or developing an infection of the wound after the operation is high. The patient requires longer hospitalization and the procedure is expensive. There is a similarity between pilonidal sinus and Shalyaja Nadi Vrana described in Susruta Samhita. Susruta has advocated a minimally invasive parasurgical treatment, viz., Kshara Sutra procedure, for Naadivrana. Hence this procedure was tried in Pilonidal Sinus. This treatment not only minimizes complication and recurrence, but also enables the patient to resume work quicker and with less discomfort.

scholarly journals Management of Pilonidal Sinus with Guggulu Aragvadha Kshara Sutra: A Case Study

2021 ◽  
Vol 11 (11) ◽  
pp. 156-160
Author(s):  
Nidhin Mohan ◽  
Ajay Kumar Gupta
Keyword(s):  
Minimally Invasive ◽  
Key Words ◽  
Pilonidal Sinus ◽  
Surgical Procedure ◽  
Primary Closure ◽  
Complete Excision ◽  
Surgical Methods ◽  
Very High

Pilonidal sinus means nest of hairs also called Jeep-bottom because it was very common in jeep drivers. It is an acquired condition commonly found in hairy males. Different surgical methods have been described for this disease such as excision and primary closure and excision with reconstructive flap, etc. However, the recurrence after surgery is very high. There is similarity between Pilonidal sinus and Shalyaja nadi vrana described in Sushruta Samhita. Acharya Sushruta has described minimally invasive Para surgical procedure viz. Kshara Sutra for Nadi vrana (Pilonidal sinus). This treatment not only minimizing the complications and recurrence but also enables the patient to resume work quickly with less discomfort. The patient attended Shalya tantra OPD of Rishikul campus, Uttarakhand Ayurved University, Haridwar and was treated with the Guggulu Aragvadha Kshara Sutra. The patient recovered well with complete excision of the tract within span of seven weeks. Key words: Pilonidal sinus, Nadi vrana, Guggulu Aragvadha Kshara Sutra.

scholarly journals Minimally Invasive Surgical Approach to Complicated Recurrent Pilonidal Sinus

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Vahit Onur Gul ◽  
Sebahattin Destek ◽  
Serhat Ozer ◽  
Ergin Etkin ◽  
Serkan Ahioglu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pilonidal Sinus ◽  
Single Phase ◽  
Surgical Techniques ◽  
Sinus Tract ◽  
Tissue Loss ◽  
Minimally Invasive Surgical ◽  
Invasive Surgical Approach ◽  
New Instruments

Pilonidal sinus is considered as a simple and frequently occurring disease localized at the sacrococcygeal area. However, at the intergluteal region, it can often turn into a chronic and complicated disease. In some cases, it can fistulize up to the gluteal region and appear at the secondary orifices. Minimally invasive surgical techniques are becoming widespread in recent years due to the increased experience and development of new instruments. Limited excision of the pilonidal sinus tract can be a better treatment option compared with large excisions in terms of recovery time and patient’s comfort. This case study reports the single-phase surgical treatment of complicated and recurrent pilonidal sinus localized at the gluteal area, with minimal tissue loss and inflammation.

scholarly journals Comparative study between excision with lay open and excision with primary closure in treatment of pilonidal sinus

2019 ◽  
Vol 6 (4) ◽  
pp. 1242
Author(s):  
B. N. Anandaravi ◽  
Aswath Viswanathan
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Open Group ◽  
Limberg Flap ◽  
Surgical Methods ◽  
Considerable Morbidity ◽  
Closure Method

Background: Pilonidal sinus is a common anorectal condition affecting young adults with various etiological factors. Various surgical methods have been described, but treatment failure and recurrence are frequent, causing considerable morbidity. This study was undertaken to study the different surgical methods in treatment of pilonidal sinus.Methods: This study was done between January 2017 and June 2018. 20 cases underwent excision with open healing and 10 cases underwent excision with primary closure. The surgeries for primary closure included Limberg flap, Karydakis technique and Z plasty. Patients were analyzed with respect to post operative complications, duration of hospital stay, duration of getting back to work and duration of wound healing.Results: Spectrum of clinical presentation included pain, discharge, sinus and swelling. No recurrences were observed in the present study. Wound infection occurred in only three cases. Duration of wound healing was found to be an average of 51.6 days in Excision with open healing method and 14.2 days in excision with primary closure method. The average length of hospital stay in excision and lay open group was 4.35 days and 5.4 days in the excision and primary closure group. The average duration to return to work was 34 days in excision and lay open group, while it was 8 days in excision and primary closure group.Conclusions: Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus.

scholarly journals AN UNUSUAL PRESENTATION OF PILONIDAL SINUS – A DIAGNOSTIC CHALLENGE!

2020 ◽  
pp. 1-2
Author(s):  
Rakesh B. S ◽  
Kavya Sivapuram ◽  
Akash Grampurohit ◽  
Sriram Madhan
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Unusual Case ◽  
Histopathological Examination ◽  
Total Excision ◽  
Cell Reaction ◽  
Common Site ◽  
Diagnostic Challenge ◽  
Submandibular Region ◽  
Sacrococcygeal Region

Introduction: Pilonidal sinus (PNS) is any subcutaneous sinus containing hair. 97.8% of PNS are in sacrococcygeal region making it the most common site of PNS. Extrasacrococcygeal PNS accounts for approximately 2.2% of PNS. Few cases of PNS of atypical sites have been reported. The purpose of this paper is to report an unusual case of pilonidal sinus over the submandibular region. Case report: A 36 year old male patient presented with a painless swelling over left side of neck since 2 weeks which on examination had no tenderness and no local raise of temperature. Ultrasonography of neck was suggestive of abscess. Excision of the swelling was done and histopathological examination showed chronic inflammation with foreign body gaint cell reaction suggesting diagnosis of Pilonidal sinus. Conclusion: Pilonidal sinus over submandibular region is unusual and a diagnostic challenge. Total excision and primary closure was done in this case.

scholarly journals Comparison between the tie-over and Karydakis procedure in chronic sacrococcygeal pilonidal sinus

2021 ◽  
Vol 23 (2) ◽  
pp. 56-61
Author(s):  
Mohammad Moazeni Bistgani
Keyword(s):  
Patient Satisfaction ◽  
Pilonidal Sinus ◽  
Wound Repair ◽  
Primary Closure ◽  
Postoperative Morbidity ◽  
Surgical Excision ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Therapeutic Modalities ◽  
Sacrococcygeal Region

Background and Aims: Pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort for the patient. Although there are various therapeutic modalities to manage these patients, Controversy for choosing the best surgical technique in order to decrease the recurrence rate, patient discomfort, and Duration of disability after surgery still exists. Therefore, the objective of the present study was to compare results reached from two methods of surgery, tie-over procedure (TOP) and Karydakis procedure(KP) for the treatment of sacrococcygeal pilonidal sinus. Methods: In this study, 70 patients with a diagnosis of pilonidal sinus disease treated randomly with surgical excision and TOP or KP, in two 35 patients group, in the educational hospital by the same surgeon, between 2009 and 2010, and followed up until December 2019. Results: Achieved data after excision of sacrococcygeal pilonidal sinus indicate that primary closure of the wound by tie-over sutures have a better result than KP in order of Pain sore during the first month after surgery (P< 0.001), Duration of disability (P <0.001), wound repair time (P <0.001) and Patient satisfaction(P=0.019). Conclusion: Overall, these results show the TOP instead of KP, because higher acceptance results may be an alternative better for the treatment of chronic pilonidal sinus for the patients who have surgery scheduled for them.

scholarly journals Z Plasty Single Center Results in The Treatment of Pilonidal Sinus Disease in Children

2020 ◽  
Vol 2 (1) ◽  
pp. 39-43
Author(s):  
Yusuf Atakan Baltrak ◽  
Seniha Esin Sogut ◽  
Onursal Varlikli
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Common Chronic Disease ◽  
Sacrococcygeal Region ◽  
Surgical Methods

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Treatment varies according to the clinical presentation of the disease. Although many surgical methods have proposed, the ideal approach is still lacking due to high recurrence rates. This study aimed to evaluate the role of Z-plasty in achieving primary recovery in pilonidal disease and morbidity and recurrence. Twenty-four patients (15 males and nine females) who underwent sinus excision and Z-plasty closure for the sacrococcygeal pilonidal sinus included in this study. Follow-up ranged from 6 to 12 months. There were 15 males and nine females with a median age of 16 years. The mean hospital stay was two days. There was no recurrence, and all patients were satisfied with the cosmetics. Two patients (5%) had numbness on the flap. No flap necrosis observed in any patient. Only three patients had a wound infection (7.5%). Wound seroma developed in five patients (12.5%). Although some technical expertise is required, excision of sinus and Z-plasty provides superior results in terms of recurrence and hospitalization of pilonidal sinus patients during hospitalization.

scholarly journals Minimally Invasive Pilonidal Sinus Treatment: A Brief Review

2021 ◽  
Vol 9 (F) ◽  
pp. 770-774
Author(s):  
Danilo Coco ◽  
Silvana Leanza
Keyword(s):  
Minimally Invasive ◽  
Pilonidal Sinus ◽  
Subcutaneous Tissue ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Chronic Infections ◽  
Invasive Treatment ◽  
Young Males ◽  
Less Is More ◽  
Disease Site

With a prevalence of 26/100,000, pilonidal sinus disease is a frequent natal cleft condition that primarily affects young males. The disease site is often uncomfortable and the disease can result in problems such as abscess formation and recurrent acute or chronic infections. Minimally invasive treatment aims to form a small elliptical wedge of subcutaneous tissue containing all the inflammatory tissue. The sinus and its lateral tracks are removed while keeping the overlying skin intact. Following the notion of “less is more,” novel least invasive treatments such as sinotomy, sinusectomy, trephining, and video-assisted and endoscopic pilonidal sinus surgery have recently been proposed. We look at minimally invasive treatments to explain how research into modern techniques has revealed a low rate of short-term problems.

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

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
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.

scholarly journals Salpingo-oophorectomy versus cystectomy in patients with borderline ovarian tumors: a systemic review and meta-analysis on postoperative recurrence and fertility

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peng Wang ◽  
Lei Fang
Keyword(s):  
Surgical Procedures ◽  
Postoperative Recurrence ◽  
Pregnancy Rates ◽  
Ovarian Tumors ◽  
Systemic Review ◽  
Cochrane Library ◽  
Risk Of Recurrence ◽  
Borderline Ovarian Tumors ◽  
Surgical Methods ◽  
Meta Analyses

Abstract Background To compare the postoperative recurrence and fertility in patients with borderline ovarian tumors (BOTs) who underwent different surgical procedures: salpingo-oophorectomy versus cystectomy. Methods Potentially relevant literature from inception to Nov. 06, 2020, were retrieved in databases including Cochrane Library, EMBASE (Ovid), and MEDLINE (Pubmed). We applied the keywords “fertility-sparing surgery,” or “conservative surgery,” or “cystectomy,” or “salpingo-oophorectomy,” or “oophorectomy,” or “adnexectomy,” or “borderline ovarian tumor” for literate searching. Systemic reviews and meta-analyses were performed on the postoperative recurrence rates and pregnancy rates between patients receiving the two different surgical methods. Begger’s methods, Egger’s methods, and funnel plot were used to evaluate the publication bias. Result Among the sixteen eligible studies, the risk of recurrence was evaluated in all studies, and eight studies assessed the postoperative pregnancy rates in the BOT patients. A total of 1839 cases with borderline ovarian tumors were included, in which 697 patients (37.9%) received unilateral salpingo-oophorectomy and 1142 patients (62.1%) underwent unilateral/bilateral cystectomy. Meta-analyses showed that BOT patients with unilateral/bilateral cystectomy had significantly higher recurrence risk (OR=2.02, 95% CI: 1.59-2.57) compared with those receiving unilateral salpingo-oophorectomy. Pooled analysis of four studies further confirmed the higher risk of recurrence in patients with cystectomy (HR=2.00, 95% CI: 1.11-3.58). In addition, no significant difference in postoperative pregnancy rate was found between patients with the two different surgical procedures (OR=0.92, 95% CI: 0.60-1.42). Conclusion Compared with the unilateral/bilateral cystectomy, the unilateral salpingo-oophorectomy significantly reduces the risk of postoperative recurrence in patients with BOT, and it does not reduce the pregnancy of patients after surgery. Trial registration PROSPERO CRD42021238177

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