scholarly journals Non surgical management of pilonidal sinus disease

2016 ◽  
Vol 63 (1) ◽  
pp. 95-100
Author(s):  
Gupta Pravin
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Low Cost ◽  
Secondary Infection ◽  
Treatment Options ◽  
Outpatient Setting ◽  
Tissue Loss ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
The One

When cosiidering how to treat pilonidal sinus, physicians should keep in mind that this condition is more than merely a particular form of foreign body granuloma. The ideal method of treatment for pilonidal sinus should be the one having minimal postoperative morbidity, excellent cosmetic results, minimal tissue loss, rapid resumption of daily activities, low cost, and a low recurrence rate. However, although numerous operative and non-operative treatment methods have been described, no approach comprises all of these features. Numerous treatment options have been proposed for the pilonidal disease, including shaving, removal with open packing, incision and drainage, excision with primary closure, phenol application, cryosurgery, excision with marsupialization, and recently, flaps surgery. The management of pilonidal sinus disease will depend on patient assessment, examination and history of the condition. A disease-specific history and physical examination should be performed, emphasizing symptoms, risk factors, and the presence of secondary infection. Conservative therapy can fairly control pilonidal sinus disease in the office outpatient setting while assuring a near-normal work status and should be pre ferred over excisional operations at the outset.

scholarly journals Management of pilonidal sinus disease with Limberg flap: our experience

2020 ◽  
Vol 7 (5) ◽  
pp. 1575
Author(s):  
Mahavir Singh ◽  
Saish Dalal ◽  
Baleshwar . ◽  
Sethu Raman
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Pilonidal Sinus Disease ◽  
Common Disease ◽  
Main Concern ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Minimal Scarring ◽  
Early Return

Background: Pilonidal sinus disease is a common disease of young adults. The management of the sacrococcygeal pilonidal sinus varies from conservative measures to various surgical procedures. The main concern for the treatment to the patient is the recurrence. Although several methods have been described all have been associated with high recurrence rates. This study was carried out to evaluate the advantages, results of rhomboid excision and limberg flap reconstruction in the management of pilonidal sinus disease.Methods: This prospective study was conducted in General Surgery department of a tertiary care centre of Haryana. It includes 29 patients who were treated for pilonidal sinus disease by Limberg flap surgery from January 2015 to January 2019.  Results: All patients were successfully treated with minimal postoperative discomfort. Only two patients developed seroma which was managed conservatively and in two patients there was slight flap tip necrosis which was also managed conservatively. Rest all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no recurrence so far.Conclusions:Limberg flap is very effective treatment for pilonidal disease. It has many advantages as it is easy to perform and design, and it flattens the natal cleft with large vascularized pedicle, sutured without tension. This in turn maintains good hygiene, reducing the friction, preventing maceration, and avoiding scar in the midline. The technique is easy to perform in quick time, useful in both primary and recurrent diseases, with very low complication and recurrence rate. Other advantages are quick healing time, short hospital stay, and early return to daily life.  

scholarly journals Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children

Children ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 187
Author(s):  
Michèle Pfammatter ◽  
Tobias E. Erlanger ◽  
Johannes Mayr
Keyword(s):  
Pilonidal Sinus ◽  
Wound Care ◽  
Outpatient Setting ◽  
Pilonidal Sinus Disease ◽  
Open Wound ◽  
Invasive Treatment ◽  
Sinus Disease ◽  
Explanatory Variables ◽  
Less Invasive ◽  
Open Wound Treatment

We aimed to compare the outcome of two different operative methods to correct pilonidal sinus disease (PSD) in children, i.e., excision and open wound care (OW) versus excision and primary transverse closure (PC) of the wound. In this retrospective, observational study, we extracted data from the medical records of 56 patients who underwent surgery for PSD at our institution between 1 January 2006 and 31 December 2016. To test whether the primary variable, i.e., rate of PSD recurrence, differed between the two surgical groups, a logistic regression model was fitted. Secondary explanatory variables were total length of stay (LOS) at the hospital, complications, sex and age of patients, seniority of the surgeon in charge, and volume of excised specimen. Overall, 32 (57%) children and young adults underwent OW, while 24 (43%) patients were treated by PC. Mean age at operation was 15.5 years in either group. PSD recurred in 12 of 32 (37.5%) children in the OW group and in 3 of 24 (12.5%) children in the PC group (ratio: 0.19, 95% confidence interval [95% CI] 0.03–1.07). Thus, treatment of primary PSD by PC proved superior with respect to PSD recurrence. Moreover, our study did not bring to light any high-grade complications in the PC group, and postoperative pain was minimal. Less invasive treatment approaches for chronic PSD are typically performed in an outpatient setting and offer reduced morbidity, low rates of PSD recurrence, and shortened periods of time to return to work or social activities. More radical operations of PSD should be reserved for recurrent PSD where less invasive approaches have failed several times.

scholarly journals Pilonidal sinus disease: Case report and review of the literature

2018 ◽  
Vol 23 (2) ◽  
pp. 86-88
Author(s):  
Olayinka A. Olawoye ◽  
Izegaegbe O. Obadan ◽  
Joshua D. Choji
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Surgical Interventions ◽  
Hygiene Measures ◽  
Disease Case ◽  
History Of ◽  
Subcutaneous Tissues ◽  
High Index Of Suspicion

Pilonidal sinus disease is a chronic granulomatous condition resulting from the presence of hair in the subcutaneous tissues. Its treatment ranges from simple hygiene measures to complex surgical interventions depending on the mode of presentation. We present a 59-year-old man who had a history of re-current swelling in the left gluteal region of about 2 years duration. After a diagnosis was made of pilonidal sinus disease, he had open surgery with laying open of the sinus and exploration with a probe in the operating room under local anesthesia. The sinus measured about 4 cm. He had drainage of the sinus cavity with curettage of the floor of the sinus. Pilonidal sinus disease may not be as uncommon in our setting as previously thought. A high index of suspicion should be entertained based on the characteristic location and typical presentation of the condition. Keywords: pilonidal sinus; pilonidal disease; pilonidal cavity 

scholarly journals Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

2012 ◽  
Vol 94 (1) ◽  
pp. 12-16 ◽  
Author(s):  
MR Venus ◽  
OG Titley
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Perforator Flap ◽  
Cosmetic Outcome ◽  
Pilonidal Sinus Disease ◽  
Wound Edge ◽  
Sinus Disease ◽  
Free Rate ◽  
The Ideal

INTRODUCTION The ideal treatment for pilonidal sinus disease has yet to be defined. There are many approaches described in the literature. METHODS Thirty-five consecutive patients who underwent wide excision of pilonidal sinus disease had the wound repaired using a parasacral perforator flap. Outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires. RESULTS There were ten minor complications including six minor wound edge dehiscences. There were two ischaemic complications, with one flap loss. There were 3 recurrences of pilonidal disease at a mean follow-up of 33 months, giving a 5-year recurrence free rate of 86%. Of the patients questioned, all would recommend the procedure to someone else despite 69% being dissatisfied with the cosmetic outcome. CONCLUSIONS This series indicates that the parasacral perforator flap technique is able to repair pilonidal sinus excision wounds successfully with minimal morbidity and a low recurrence rate at a mean of follow-up of 33 months. The study suggests that it may be a technique best reserved for recurrent cases of pilonidal sinus disease. Patients feel the procedure is successful despite reservations regarding the cosmetic outcome.

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 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.

Long-term Results of Pilonidal Sinus Disease with Modified Primary Closure: New Technique on 450 Patients

2014 ◽  
Vol 80 (5) ◽  
pp. 484-488 ◽  
Author(s):  
Marco Gallinella Muzi ◽  
Riccardo Maglio ◽  
Giovanni Milito ◽  
Casimiro Nigro ◽  
Ilaria Ciangola ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Return To Work ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Long Term Follow Up

Chronic pilonidal disease is a debilitating condition that typically affects young adults. Controversy still exists regarding the best surgical technique for the treatment of pilonidal disease in terms of minimizing disease recurrence and patient discomfort. The present study analyzes the results of excision with our modified primary closure. This retrospective study involving consecutive patients with pilonidal disease was conducted over a 6-year period. From January 2004 to January 2010, 450 consecutive patients with primary pilonidal sinus disease received this new surgical treatment. Times for complete healing and return to work, the duration of operation and of hospitalization, postoperative pain, time to first mobilization, and postoperative complications were recorded. To evaluate patient comfort, all patients were asked to complete a questionnaire including visual analog scale. The median long-term follow-up was 54 months (range, 24 to 84 months). Four hundred fifty consecutive patients (96 female, 354 male) underwent excision. The median age was 25 years (range, 17 to 43 years). The median follow-up period was 54 months (range, 24 to 84 months). Four hundred twenty completed questionnaires were returned (87% response rate). The median duration of hospital stay was eight hours (range, 7 to 10 hours) No patient reported severe postoperative pain. Primary operative success (complete wound healing without recurrence) was achieved in 98.2 per cent. Two (0.5%) patients had a recurrence. The mean time lost to work/school after modified primary closure was eight days. Excision and primary closure with this new technique is an effective treatment for chronic pilonidal disease. It is associated with low morbidity, early return to work, and excellent cosmetic result and a high degree of patient satisfaction in the long-term follow-up.

Results of Crystalized Phenol Application in the Treatment of Pilonidal Sinus Disease in Children: Our Single Center Experience

2021 ◽  
Author(s):  
Yusuf Atakan Baltrak ◽  
Seniha Esin Söğüt ◽  
Onursal Varlıklı
Keyword(s):  
Pilonidal Sinus ◽  
Low Cost ◽  
Area Measurement ◽  
Pilonidal Sinus Disease ◽  
Index Number ◽  
Imaging Method ◽  
Success Rates ◽  
Sinus Disease ◽  
Single Center Experience

Objective: The debate about the etiology of Pilonidal Sinus Disease (PSD) continues over whether the disease is congenital or acquired. After determining the etiologic factora, new pilonidal sinus treatment methods have been developed. Method: The 6-month follow-up results of patients who were treated with crystallized phenol (CF) application with the diagnosis of PSD between March 2020 and August 2020 in the Pediatric Surgery Clinic were retrospectively analyzed. The patients were evaluated by age, height, weight, gender, body mass index, number of sinus mouths, sinus mouth width, sacral cupping distance and cyst diameter by imaging method and pilonidal sinus area measurement. After three consecutive weeks of CF administration, a two-week break was given. Every three weeks of treatment was considered as one treatment cycle. CF treatment was considered unsuccessful for patients whose pilonidal sinus cavity was not closed at the end of three cycles and the complaint of discharge persisted. Results: During the study period, 21 patients with PSH and a maximum of three sinus orifices were treated with CF in our clinic. Including 15 (71.4%) male and 6 (18.6%) female cases. The median age of the patients was 16 (14-17.5) years. In two patients (9.5%) who received three cycles of treatment, the treatment was considered as CF treatment failure because of the persistence of discharge complaints, and surgical treatment was planned for the patient. In the findings obtained as a result of the follow-up of the patients, it was observed that three patients (14.2%) had temporary painless transient dermatitis during follow-up due to phenol applied. Conclusion: The application of CF in the PSD treatment in pediatric age group should be considered as an acceptable method that can be easily applied by any surgeon with its short hospital stay, its applicability under local anesthesia in outpatient clinic conditions, low postoperative complications, high success rates, and low cost.

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

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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