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.

Surgical reconstruction of pilonidal sinus disease with concomitant extracellular matrix graft placement: a case series

2021 ◽  
Vol 30 (Sup7) ◽  
pp. S28-S34
Author(s):  
Abigail E Chaffin ◽  
Shane G Dowling ◽  
Mychajlo S Kosyk ◽  
Brandon A Bosque
Keyword(s):  
Extracellular Matrix ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Case Series ◽  
Surgical Reconstruction ◽  
Pilonidal Sinus Disease ◽  
Surgical Approaches ◽  
Flap Reconstruction ◽  
Recurrence Rates ◽  
Sinus Disease

Background: Pilonidal sinus disease (PSD) is a chronic inflammatory disease affecting the soft tissue of the sacrococcygeal region and remains a challenging disease for clinicians to treat. The optimal treatment for PSD remains controversial and recent reports describe several different surgical approaches offering different benefits. Approximately 40% of initial incision and drainage cases require subsequent surgery. Due to high recurrence rates and postoperative complications, a more complex revision surgery involving a flap reconstruction may be required. We hypothesised that the combination of an extracellular matrix (ECM) graft with tissue flap reconstruction may decrease the postoperative complications and recurrence rates for PSD. Method: We report a retrospective case series using a surgical flap reconstruction with concomitant implantation of an ovine forestomach ECM graft under a fasciocutaneous flap with an off-midline closure for recurrent PSD, where previously surgical intervention had failed due to wound dehiscence and/or recurrent disease. Results: The case series included six patients. After three weeks, all patients except one were fully healed, and the sixth was fully healed by week 4; all wounds remained fully healed at 12 weeks. All patients achieved good cosmesis and were able to return to normal function without any residual symptoms. Conclusion: This pilot case series explored augmenting a flap reconstruction for complex PSD with advanced ECM graft materials, demonstrating that it may improve outcomes and minimise typical complications seen in flap closure, such as inflammation, infection, haematoma/seroma and hypoperfusion. Although the study had a limited number of participants, long-term outcomes were promising and suggest that further studies are warranted.

scholarly journals The limberg flap reconstruction – the optimal surgery for pilonidal sinus disease

2016 ◽  
Vol 7 (3) ◽  
pp. 271-275
Author(s):  
Ramu Shapur Srihari ◽  
Appaji Mandya Naveen ◽  
Harinatha Sreekar
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Sinus Disease

Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate

2010 ◽  
Vol 180 (1) ◽  
pp. 173-176 ◽  
Author(s):  
S. N. S. Gilani ◽  
H. Furlong ◽  
K. Reichardt ◽  
A. O. Nasr ◽  
G. Theophilou ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease

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 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 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.

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