scholarly journals Surgical Treatment of Sacrococcygeal Pilonidal Sinus with a Leaf Flap

2021 ◽  
Vol 17 (2) ◽  
pp. 102-107
Author(s):  
Jun Hyun Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Han Gyu Cha
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Complication Rates ◽  
Flap Surgery ◽  
Easy Method ◽  
Transposition Flap ◽  
Young Males ◽  
Minimal Incision ◽  
Flap Procedure ◽  
Time Required

Background: Pilonidal sinus, occurring in 7% of the population, is a disease found in the cleavage of the buttocks, typically in young males after puberty. This study explored the utility of the leaf flap, a unilobed fasciocutaneous transposition flap, as a reconstructive method for treating pilonidal sinus on the sacrococcygeal area.Methods: We present cases of eight patients with pilonidal sinus who underwent unilobed fasciocutaneous transposition flap surgery. Patients complaining of an abscess in the sacrococcygeal region were initially treated with a minimal incision to drain the abscess, and 14 days of antibiotics administration. Afterwards, the patients were re-evaluated at the outpatient clinic and scheduled for a leaf flap procedure 4 weeks after drainage. Hospitalization, the time required for full activity, and complication rates were recorded.Results: Minor postoperative complications were observed in one patient (12.5%). The patient required re-suturing of his wound due to an infection and wound dehiscence. The mean hospitalization was 10 days (range, 5–23 days), and the period required to return to daily activities was 4 weeks.Conclusion: The leaf flap procedure is recommended because it is a relatively easy method for surgeons, and also because the flap has abundant perfusion. This surgical method was used as the first treatment of choice for sacrococcygeal pilonidal sinus, with the advantages of less patient discomfort, fast healing of the site and short hospitalization. Our results support the leaf flap surgery as a favored treatment for pilonidal sinus.

Modified Limberg Flap Cover for Recurrent Sacrococcygeal Pilonidal Sinus: Our Experience at a Medical College In Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1274-1279
Author(s):  
Budhi Nath Adhikari ◽  
Abhishek Bhattarai ◽  
Pragya Devkota ◽  
Sushma Khatiwada
Keyword(s):  
Patient Satisfaction ◽  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Transposition Flap ◽  
Young Males ◽  
Modified Limberg Flap ◽  
The Mean ◽  
Rhomboid Excision

Introduction: Pilonidal sinus is an inflammatory disease seen mostly in the intergluteal region of young males. Although any treatment strategy of this condition is generally free of life-threatening complications due to its superficial nature, it is still a feared disease because of recurrence which greatly increases the morbidity. Objective: To investigate the results of wide rhomboid excision and modified Limberg transposition flap reconstruction to treat recurrent pilonidal sinus. Methodology: Well-documented records of all patients with recurrent sacrococcygeal pilonidal sinus who underwent wide excision and a modified Limberg transposition flap at our center during the past 3 years and followed up for longer than 12 months were analyzed. The modification primarily consisted of an asymmetrically rotated rhomboid excision and lateralization of the lower midline. Patient demographics, days of hospitalization, complications, patient satisfaction and recurrence rates were evaluated. Result: Most patients in the study were overweight. No relationship was detected between BMI and number of sinus openings, hospital stay, drain placement or recurrences but an association with infection was noted. The number of pilonidal sinus orifices did not have a correlation with age, number of previous surgeries, duration of hospital stay or drains placement. The mean duration of hospitalization was 7.89 ± 3.41 days and the mean duration of suction drainage was 6.33±2.87 days. Half of our patients developed complications in the postoperative period. The only patient who developed superficial wound infection stayed the most in the hospital. All patients had some complaints regarding the operation site; however, they were satisfied with the result of the operation and had no recurrence at 12 months of follow-up. Conclusion: Rhomboid excision of recurrent sacrococcygeal pilonidal sinus with modified Limberg flap closure is a promising surgical technique with advantages of a good patient satisfaction and no recurrence after a year of surgery.

scholarly journals Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure

2014 ◽  
Vol 99 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Fatih Altintoprak ◽  
Kemal Gundogdu ◽  
Tolga Ergonenc ◽  
Enis Dikicier ◽  
Guner Cakmak ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Early Discharge ◽  
Long Term Results ◽  
Limberg Flap ◽  
Flap Necrosis ◽  
Flap Procedure ◽  
Short And Long Term

Abstract The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6–72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.

Pilonidal sinus disease: Karydakis flap procedure in our patients

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.

Day case locked anterior plating for distal radial fractures is safe with uninterrupted antithrombotic therapy

2020 ◽  
pp. 175319342096623
Author(s):  
James A. Morris ◽  
Max Little ◽  
Thomas Ashdown ◽  
Oliver T. Clough ◽  
Timothy Packer ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Complication Rates ◽  
Day Case ◽  
Antithrombotic Treatment ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Excessive Bleeding ◽  
Superficial Wound ◽  
Surgical Fixation ◽  
Anterior Plating

We undertook a matched prospective cohort study over a 4-year period to examine the safety of continuing the administration of regular antithrombotic treatment with warfarin, clopidogrel or aspirin during day case surgical fixation of distal radial fractures. One hundred and one patients were identified and consented to participate in this study. There was only one reported complication: a superficial wound infection treated with antibiotics. No episodes of excessive bleeding were noted intraoperatively. All patients were discharged home on the day of surgery and there were no episodes of readmission, significant bleeding, haematoma requiring intervention, compartment syndrome or wound dehiscence. Complication rates were comparable with those of the matched cohort of patients undergoing the same procedure but who were not taking antithrombotic medications. Level of evidence: IV

scholarly journals Limberg Flap is a Safe and Effective Procedure for the Surgical Treatment of Pilonidal Sinus in Sacrococcygeal Region

2021 ◽  
Vol 12 (1) ◽  
pp. 6-8
Author(s):  
Md Rashidul Islam ◽  
Abul Bashar Md Abdul Matin ◽  
Sami Ahmad ◽  
Md Armanul Islam ◽  
Shoaeb Imtiaz Alam
Keyword(s):  
Postoperative Pain ◽  
Pilonidal Sinus ◽  
Young Male ◽  
Main Concern ◽  
Limberg Flap ◽  
Suction Drain ◽  
Sacrococcygeal Region ◽  
Flap Procedure ◽  
Secondary Closure

Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young male adults. Diagnosis is indicated by to see the site and appearance of chronic discharging opening, and identification of midline pit in the natal cleft. The management of the sacrococcygeal pilonidal sinus varies from clipping of hairs with good hygiene of the area, wide excision of the area with primary or secondary closure and newer flap procedures, but none is widely accepted. The main concern for the treatment to the patient is the recurrence. This prospective study has been performed to determine the effectiveness and safety of the Limberg flap procedure for sacrococcygeal pilonidal sinus for new and recurrent cases. Primary end point was rate of recurrence and secondary end points were its complianceand complications such as wound infection, postoperative pain and return to work. A total of 17 patients were operated from March 2012 to June 2016.Both primary and recurrent diseases were included. All patients successfully underwent surgery. Patients complained very minimal postoperative pain. LO were average 2 days. All patients were discharged with negative suction drain in situ. Drains were removed on 7th POD and stitches were removed on 9th to 12th postoperative day. All patients returned to work after 2nd weeks. In our study no recurrence or major complications were found. Limberg flap for sacrococcygeal pilonidal sinus was found very useful and effective in terms of recurrence rate and patients morbidity. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 6-8

scholarly journals A comparative study for production of germ tube in Candida albicans of various pulmonary samples, by different methods in a tertiary care hospital of south west Rajasthan

2021 ◽  
Vol 8 (12) ◽  
pp. 5968
Author(s):  
Upasana Bhumbla ◽  
Amit Gupta
Keyword(s):  
Candida Albicans ◽  
Germ Tube ◽  
Tertiary Care ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tube Production ◽  
Easy Method ◽  
Yeast Extract Peptone Dextrose ◽  
Sugar Fermentation ◽  
Time Required

Background: Systemic candidiasis is associated with a high crude mortality rate, even with first line antifungal therapy. C. albicans is the predominant cause of invasive fungal diseases which is a serious public health issue. The main objective was to assess the reliability of different media for germ tube production in Candida albicans isolated from various clinically diagnosed pulmonary samples.Methods: All Candida isolates were identified and speciated by conventional methods such as Gram’s staining, germ tube test, chlamydospore formation on corn meal agar, sugar fermentation test, sugar assimilation test, and growth on Hi-chrome candida agar.Results: Out of 108 clinical isolates of Candida albicans, 5 different methods were used for germ tube production. Pooled human sera showed 93/108 (86.1%) was the most sensitive method wherein YEPD (yeast extract peptone dextrose) broth 91/108 (84.7%) was the reliable and easy method for detection of germ tube, followed by trypticase soy broth 81/108 (81.4%); peptone water 80/108 (74.7%) and 2% sucrose 71/108 (65.7%).Conclusions: YPED broth is found to be a better serum free substrate and subsequently for the presumptive differentiation of C. albicans from non-albicans candida (NAC), without the extensive time required for the preparation and testing of pooled human serum. Furthermore, this medium is commercially available, more stable, effective, and is not bio hazardous.

A direct radioimmunoassay for aldosterone in unextracted serum and plasma.

1981 ◽  
Vol 27 (12) ◽  
pp. 2019-2021 ◽  
Author(s):  
T P Lee ◽  
C H Tan
Keyword(s):  
Polyethylene Glycol ◽  
Proteolytic Enzyme ◽  
Binding Proteins ◽  
Proteinase K ◽  
Serum Samples ◽  
Easy Method ◽  
Direct Estimation ◽  
Extraction And Purification ◽  
Counting Time ◽  
Time Required

Abstract We describe a novel radioimmunoassay procedure for the direct estimation of aldosterone in unextracted plasma and serum samples, in which interfering binding proteins are digested by Proteinase K (Tritirachium alkaline proteinase, EC 3.4.21.14), a powerful proteolytic enzyme. Heating at 75 degrees C for 15 min inactivates the enzyme before radioimmunoassay. Alternatively, EDTA may be used to inactivate the enzyme. The antibody-bound fraction is then precipitated with polyethylene glycol and isolated by centrifugation. This easy method eliminates extraction and purification and gives accurate and reliable results. The total time required for 100 estimations, including counting time, is about 6 h.

scholarly journals Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Kamil Yildiz ◽  
Erkan Ozkan ◽  
Hacı Mehmet Odabaşı ◽  
Bülent Kaya ◽  
Cengiz Eriş ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pilonidal Sinus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Satisfaction Rate ◽  
Flap Procedure ◽  
The Mean

Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique.Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction.Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%).Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

Results of surgical treatment of pilonidal sinus in 50 patients operated by the Bascom 2 method – prospective study

2019 ◽  
Vol 91 (5) ◽  
pp. 1-5
Author(s):  
Paweł Dutkiewicz ◽  
Przemysław Ciesielski ◽  
Małgorzata Kołodziejczak
Keyword(s):  
Quality Of Life ◽  
Wound Healing ◽  
Pilonidal Sinus ◽  
Surgical Care ◽  
Wound Dehiscence ◽  
Healing Time ◽  
Physical And Mental Health ◽  
The World ◽  
Wound Healing Time

Introduction: Treatment of the pilonidal sinus, due to the various surgery method, remains the current topic of discussion during surgeon meetings around the world. The newest methods of treatment consist in the excision and simultaneous closure of the wound with the cleft lift techniques. One of such methods is the Bascom 2 technique widely used in the world and less popular in Poland. Aim of the study: To evaluate the results of treatment of pilonidal cysts using the Bascom 2 method performed by one operator. Material and method: 50 patients (40 men, 10 women), Avg. 30.6 years of age, All patients treated with the Bascom 2 method in one surgical ward by one operator (resident during specialization training) with the use of a uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalization time, pain, post-operative complications, wound healing time, patient's quality of life, and the percentage of recurrences after surgery. The follow-up period ranged from 12 to 52 months. Results: Average BMI 27.13 kg / m2. Avg. time of hospitalization 2.95 days. Postoperative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day of. 2.04 points (+/- 1.58 points); in the 30th day of the 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Postoperative complications occurred in 28.57% of patients (partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%). The average time of full healing was 2.94 weeks. The recurrence occurred in one patient (2.04%). Conclusions: Bascom 2 method is characterized by low recurrence rate and short wound healing time. It is a safe, effective and patient-accepted treatment method. Statistically significantly improves the patient's quality of life one year after surgery in terms of both physical and mental health.

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