scholarly journals Reconstruction of Pilonidal Sinus by Rhomboid Flap : Our Experience

2018 ◽  
Vol 16 (2) ◽  
pp. 17-19
Author(s):  
Md Saiful Hoque ◽  
Tahmina Akther Chowdhury ◽  
Saifuddin Ahmed Siddique ◽  
Md Saiful Islam
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Healing Time ◽  
Sinus Surgery ◽  
Common Disease ◽  
Transposition Flap ◽  
Shorten Hospital Stay ◽  
Long Duration ◽  
Rhomboid Flap ◽  
Early Healing

Background: Pilonidal sinus is a common disease of young adult usually caused by insertion of fallen hair into skin (Gluteal cleft). Wide excision surgery is a common practice but due to high recurrence and long duration of healing there are more simple alternatives. Our experience with transposition of Rhomboid flap in the treatment of pilonidal sinus are described. The conventional way of treatment of pilonidal sinus is block excision and lay open of the sinus result in 5-14 days hospital stay healing time of 6-10 weeks. In our study all patients hospital stay was 2-3 days, healing time was less than two weeks with minimum complication. The aim of the study is to do rhomboid flap for the treatment of pilonidal sinus, so to avoid complications and recurrence, to shorten hospital stay and to give better outcome.Methods: Total 6 patients of 18-40 years of age after doing all investigations and clinical examinations, excision of pilonidal sinus was done and repaired by rhomboid transposition flap in the same setting. All the patients were followed up post operatively for 3 months to see any discharging sinus.Results: All 6 patients were discharged on 3rd post operative day and stitches were removed on 8th post operative day and approximate time to resume their work is 14 days.Conclusion: Pilonidal sinus surgery is a challenging operation for the surgeon because of recurrence and complication. Rhomboid flap technique has become familial because of its advantage of early healing, less hospital stay and very low recurrence rate.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 17-19

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.

OUTCOME OF RHOMBOID FLAP AND Z-PLASTY IN PILONIDAL SINUS SURGERY

2015 ◽  
Vol 5 (2) ◽  
pp. 139-146 ◽  
Author(s):  
AbdulWahid M. Salih ◽  
◽  
Hawar Hasan Ali Ghalib ◽  
Diary A. Ismael ◽  
◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Sinus Surgery ◽  
Rhomboid Flap

scholarly journals Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 119 (4) ◽  
pp. 148-155 ◽  
Author(s):  
Abdulcabbar Kartal ◽  
Hüseyin Onur Aydın ◽  
Mehmet Oduncu ◽  
Murat Ferhat Ferhatoğlu ◽  
Taner Kıvılcım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Transposition Flap ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.

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 Laying Open and Curettage under Local Anesthesia to Treat Pilonidal Sinus: Long-Term Follow-Up in 111 Consecutively Operated Patients

2021 ◽  
Vol 11 (2) ◽  
pp. 193-199
Author(s):  
Pankaj Garg ◽  
Vipul D. Yagnik
Keyword(s):  
Hospital Stay ◽  
Local Anesthesia ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Operating Time ◽  
Healing Time ◽  
Long Term Follow Up ◽  
Normal Work

(1) Background: Several techniques for the treatment of pilonidal sinus disease (PSD) are in vogue, though none have emerged as the gold standard. Laying open (deroofing) and curettage under local anesthesia is one of the most straightforward procedures to treat PSD. In this study, the long-term follow-up in a large series was analyzed. (2) Methods: The laying open approach was performed for all types of consecutive PSD patients—simple, complicated, and abscess. The primary outcome parameter of the study was the healing rate. The secondary outcome parameters were operating time, hospital stay, time to resumption of normal work, and healing time. (3) Results: 111 (M/F–92/19, mean age-22.9 ± 5.7 years) consecutive patients were operated on and followed for 38 months (6–111 months). Of these, 24 had pilonidal abscesses, 87 had chronic pilonidal disease, while 22 had recurrent disease. Operating time and hospital stay were 24 ± 7 min and 66 ± 23 min, respectively. On average, patients could resume normal work in 3.6 ± 2.9 days and the healing time was 43.8 ± 7.4 days. Three patients were lost to follow-up. Complete resolution of the disease occurred in 104/108 (96.3%) patients, while 4 (3.7%) had a recurrence. One recurrence was due to a missed tract, while three recurrences presented after complete healing had occurred. Two patients with recurrence were operated on again with the same procedure, and both healed completely. Thus, the overall success rate of this procedure was 98.1% (106/108) with a recurrence rate after first surgery of 3.7% over a median follow-up of 38 months. (4) Conclusions: Pilonidal disease managed by laying open (deroofing) with curettage under local anesthesia is associated with a high cure rate. This procedure is effective in treating all kinds of pilonidal disease (simple, complicated, and abscess).

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 Comparison of Crystallized Phenol Treatment and Simple Primary Closure Methods for Pilonidal Sinus Disease

2019 ◽  
Vol 103 (9-10) ◽  
pp. 424-428
Author(s):  
Ahmet Turkoglu ◽  
Zubeyir Bozdag ◽  
Metehan Gumus ◽  
Abdullah Oguz ◽  
Mesut Gul ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Healing Time ◽  
Pilonidal Sinus Disease ◽  
Complication Rates ◽  
Female Ratio ◽  
Sinus Disease ◽  
Phenol Treatment ◽  
Crystallized Phenol

The objective of the study was to compare the results of the patients treated with crystallized phenol treatment (CPT) or simple primary closure (SPC) for pilonidal sinus disease (PSD). For PSD treatment, both SPC and CPT have the advantages of rapid recovery, minimal pain, and short hospital stay. Even though these two techniques can be used interchangeably in uncomplicated cases, there is not enough evidence about which method is superior. A total of 102 patients who underwent CPT (n = 57) and SPC (n = 45) for uncomplicated PSD were included in the study. In all of the cases, data were recorded and compared between CPT and SPC groups, including age, gender, duration of the symptoms, hospital stay, complications, healing time, and recurrence. The mean age was 25.6 years and the male-to-female ratio was 93:9. The SPC and CPT groups were similar in terms of age, gender, duration of symptoms, complications, and healing time. The CPT group did not require hospitalization or anesthetic procedure in addition to local anesthesia, but the SPC group required a median of 1 day (range, 1–3 days) of hospitalization, and 3 patients (6.7%) needed spinal anesthesia. During a median of 27.5 months' follow-up, the recurrence rate in the CPT group (6 patients; 10.5%) was lower than in the SPC group (13 patients; 28.9%). Both hospital stay and recurrence rates were better in the CPT group. Healing time and complication rates were similar in both methods. Based on these results, we suggest that CPT should be preferred to SPC in uncomplicated cases.

Pilonidal Sinus : Management through Guggulu Apamarga Ksharasutra

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Sanjay Kumar Agri ◽  
Dr. Pankaj Sharma ◽  
Dr. Ajay Kumar Gupta
Keyword(s):  
Pilonidal Sinus ◽  
Burning Sensation ◽  
Purulent Discharge ◽  
Common Disease ◽  
Daily Routine ◽  
Routine Work

Nowadays Pilonidal Sinus (PNS) is becoming common disease in between 20-30 years of age, in men and mostly dense hairy persons. Commonly it occurs midline over the coccyx. It results in purulent discharge, pain and discomfort. In Ayurvedic practice, there are many surgeons who are practicing classical Ksharasutra management to treat PNS, which is very effective but there are some problems using classical Ksharasutra in the management of PNS, such as discomfort, burning sensation, itching and irritation due to Snuhi-ksheera. So to overcome these problems Guggulu Apamarga Ksharasutra has been used, which is very effective in curing PNS and has no complications. So patients can do their daily routine work without any pain or discomfort.

CLINICAL CHARACTERISTICS AND EVALUATION OF THE EFFECTIVE TREATMENT OF CUTANEOUS WARTS BY ELECTROSURGERY

2020 ◽  
pp. 25-29
Author(s):  
Anh Mai Ba Hoang ◽  
Duan Nguyen Duy ◽  
Cat Mai Thi Cam ◽  
Nga Le Thi Thuy ◽  
Phuong Nguyen Thi Thanh ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Wide Distribution ◽  
Healing Time ◽  
Common Disease ◽  
Clinical Form ◽  
Plantar Wart ◽  
Dermatology Clinic ◽  
Cutaneous Wart ◽  
Cutaneous Warts ◽  
Single Lesion

Background: Cutaneous wart is a common disease caused by the infection of Human Papillomavirus, this disease has diverse clinical characteristics and many different treatments. We conducted this study to evaluate the clinical features and the efficacy electrosurgery treatment. Methods: A total 75 patients was diagnosed with cutaneous wart and treated by electrosurgery method at Dermatology Clinic of Hue University of Medicine and Pharmacy Hospital. Results: The age has a wide distribution. The female/male ratio was nearly egal. Most patients had a single lesion. Plantar wart was predominate with 63.3%. After the procedure, 90.8% of patients had mild and moderate pain. The rate of post-operative bleeding was high 85.3%. In the first week, the dried wound was 64.2%. The average healing time was about 4 weeks. The infection rate was 11%. Conclusion: The most common clinical form was plantar wart; electrosurgery had many advantages but some disadvantages in wound healing related to heat damage. Keywords: cutaneous wart, electrosurgery, HPV.

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