scholarly journals Z- Plasty: an Effective Technique for Pilonidal Sinus

2021 ◽  
Vol 28 (2) ◽  
pp. 164-171
Author(s):  
Mohammad Rabiul Karim Khan ◽  
Most Nurunnahar Begum ◽  
Sharmin Islam ◽  
Abu Faisal Md Ariful Islam ◽  
Rafiq Uddin Ahmed ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Prospective Observational Study ◽  
Wound Dehiscence ◽  
Effective Technique ◽  
Natal Cleft ◽  
Medical College ◽  
Lower Recurrence Rate ◽  
Surgical Options

Introduction: Pilonidal sinus is a commonly encountered problem with multiple surgical options. With Z- plasty, primary closure ensues faster healing while the alteration of local anatomy reduces recurrence. The extremely low recurrence rate following Z-plasty for pilonidal sinus results from the fact that the operation was planned with the true physiology of the disease in mind. It is the deep natal cleft which predisposes to pilonidal sinuses and this architecture is altered with multiple Z -plasty. Materials and methods: A prospective, observational study was conducted into department of Plastic Surgery and burn, Dhaka Medical College and Hospital. Here 18 patients with pilonidal sinus were treated by Z – plasty between 2013 to 2018. Result: There was only one recurrence during the follow up time. There were no necrosis of flaps and no wound dehiscence. Conclusion: The Z-plasty technique is an effective procedure for treating pilonidal sinus in terms of both faster healing and lower recurrence rate. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 164-171

scholarly journals Sinus Excision, Release of Coccycutaneous Attachments and Dermal-Subcuticular Closure (XRD Procedure): A Novel Technique in Flattening the Natal Cleft in Pilonidal Sinus Treatment

2008 ◽  
Vol 90 (5) ◽  
pp. 371-376 ◽  
Author(s):  
Deya M Marzouk ◽  
Ahmed A Abou-Zeid ◽  
Anthony Antoniou ◽  
Amyn Haji ◽  
H Benziger
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Normal Activity ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Novel Technique ◽  
Before And After ◽  
A New Technique

INTRODUCTION The objective of this study was to analyse, prospectively, the outcome of a new technique – excision of pilonidal sinus and flattening the natal cleft by division of the coccycutaneous attachments at the lower end of the incision. PATIENTS AND METHODS Sixty-six consecutive patients with chronic pilonidal sinuses were treated between 1995 and 2001. The procedure consisted of an elliptical, wide, local excision, release of the coccycutaneous attachments and primary closure using dermal-subcuticular closure (XRD). Suction drains were used until drainage was minimal. The height of skin level at the lower angle of the wound from the coccyx was measured intra-operatively before and after division of the coccycutaneous attachments. Postoperatively, patients were assessed for hospital stay, return to normal activity, complications and recurrence. RESULTS Sixty-four patients (97%) were males, median age 27 years. The height of skin level rose from a mean of 1.8 cm (95% CI, 1.78–1.85) to a mean of 3.8 cm (95% CI, 3.77–3.88; P < 0.001). Morbidity affected 12 patients (18%), epidermal separation of the lower wound angles (6 patients), seromas (5 patients) and 1 wound dehiscence at 2 weeks. All other wounds healed primarily without dehiscence. There were no recurrences after a median follow-up of 22.5 months (range, 12–38 months). CONCLUSIONS Release of the coccycutaneous attachments is an easy technique to learn, which seems to be an effective way of flattening the natal cleft and may result in lower recurrence rate. This technique should be tried in uncomplicated pilonidal sinus disease before more complex procedures are attempted.

Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

2020 ◽  
Vol 22 (2) ◽  
pp. 89-94
Author(s):  
Nasir Uddin Mahmud ◽  
ABM Khurshid Alam ◽  
Mohammad Altaf Hossain Chawdhury ◽  
Mohammad Abul Khair
Keyword(s):  
Pilonidal Sinus ◽  
Skin Barrier ◽  
Limberg Flap ◽  
College Hospital ◽  
Medical College ◽  
Flap Technique ◽  
Unpleasant Smell ◽  
Lower Morbidity ◽  
Computer Operator

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance. Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017. Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period. Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity. Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

scholarly journals TO DETERMINE THE RECURRENCE RATE OF STRICTURE URETHRA FOLLOWING OPTICAL URETHROTOMY IN DEPARTMENT OF UROLOGY AT PEOPLE’S MEDICAL COLLEGE HOSPITAL NAWABSHAH, A 2 YEARS’ EXPERIENCE.

2019 ◽  
Vol 26 (07) ◽  
pp. 1101-1107
Author(s):  
Salman Manzoor Qureshi ◽  
Muhammad Ali Sohail ◽  
Aijaz Hussain Memon ◽  
Mujeeb ur Rehman Sahito ◽  
Muhammad Shahid Bhatti ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Medical College Hospital ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
Multiple Factors ◽  
Stricture Urethra ◽  
Retrograde Urethrogram ◽  
Open Surgical Procedure

Objectives: To determine the recurrence rate of Stricture Urethra following Optical Urethrotomy in department of Urology at people’s medical college hospital Nawabshah, a 2 years’ experience. Study Design: Prospective observational. Setting: Department of Urology at People’s Medical College Hospital Nawabshah. Period: January 2016 to January 2018. Methodology: Patients who fulfill inclusion criteria were admitted through Urology OPD. An informed consent was taken. All baseline investigations / Antegrade and Retrograde Urethrogram, Qmax in uroflowmetery, post void residual ultrasound scan were performed in all cases. The patients were asked to attend the OT after anesthetic assessment, under spinal anesthesia. They were advised to have follow-up visits with uroflowmetery and PVR. All the collected data was filled on Performa. Data was analyzed through SPSS Version 20.0. Results: A total of 95 patients (100 %) underwent first session of DVIU, out of 95 patients 37 patients (38.95 %) showed improvement in subjective, while remaining 58 patients (61.05%) showed deterioration. so they underwent second session of DVIU. After second session of DVIU 15 patients (25.86%) out of remaining 58 patients showed improvement, while 43 patients (74.14%) remained in agony, So I counseled them all (remaining 43 patients) for third sitting of DVIU or open urethroplasty. Out of 43 remaining patients only 23 patients willingly underwent third session of DVIU and remaining 20 patients refused and they directly underwent open end to end urethroplasty. The 23 patients, who underwent DVIU, have failed and finally they also underwent urethroplasty. Conclusion: The recurrence rate after DVIU has based on multiple factors that should be properly addressed during treatment planning to avoid unnecessary re treatment, to decrease the rate of more invasive open surgical procedure.

scholarly journals A COMPARATIVE CLINICAL STUDY OF ‘CHEDANA KARMA & KSHARSUTRA (SETON) KARMA’ (GUGGULU BASED) IN THE MANAGEMENT OF SHALYAJ NADI VRANA(SINUS) W.S.R. TO PILONIDAL SINUS (ASSOCIATED WITH ROPAN LEPA)

2021 ◽  
Vol 9 (2) ◽  
pp. 327-334
Author(s):  
Syed Abdul Wahid ◽  
Arvind Gajbhiye
Keyword(s):  
Clinical Study ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Common Disease ◽  
Natal Cleft ◽  
Surgical Interventions ◽  
Comparative Clinical Study ◽  
Ayurvedic Treatment ◽  
Treatment Aspect

A Pilonidal Sinus is a common disease of the natal cleft. Pilonidal Sinus is a track which contains hairs. The incidence of the disease is calculated to be 26 per 100,000 people. Pilonidal disease has a male pre-dominance with a ratio of 3:1. There are several methods to treat pilonidal sinus, but the recurrence rate is more in modern surgical interventions. According to Ayurveda it can be correlated to Salyajanya Nadi Vrana (pilonidal sinus), a type of Nadi Vrana (sinus). Whose etiopathology is described in Nidanasthana and treatment aspect in Chikitsasthana of Susrutha Samhita. Susrutha mentioned the ap-plication of Kshara (caustic alkali) and Ksharsutra (Seton) (Seton) in the management of Nadi Vrana (si-nus). Studies show that by Ayurvedic treatment, it helps to reduce recurrence rate, even though Nadi Vrana (sinus) is said to be Kricchrasadhya (difficult to cure). Hence successful management of this disease de-pends on the knowledge of pathogenesis, patient’s presentation and knowledge on treatment aspects. In this Clinical study, effect of Chedana karma & Ksharsutra (Seton) karma’ (Guggulu based) in the management of Salyajanya Nadi Vrana (pilonidal sinus) w.s.r. To pilonidal sinus (associated with ropan lepa) is seen and conclusion in drawn.

scholarly journals Prospective study of radiation related adverse events and its management in cancer patient at tertiary care teaching hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 451
Author(s):  
Rohit . ◽  
Devesh Kumar Joshi ◽  
Raja Paramjeet Singh Banipal
Keyword(s):  
Radiation Therapy ◽  
Adverse Events ◽  
Prospective Observational Study ◽  
Background Radiation ◽  
Tertiary Care ◽  
Clinical Results ◽  
Medical College ◽  
Burden Of Treatment ◽  
Patient Burden

Background: Radiation therapy is associated with certain adverse events which may cause significant discomfort to patient and may affect patient’s life. The objective of the study was to assess radiation related adverse events in the patients who are on radiation therapy and to prevent and manage these adverse events.Methods: A prospective observational study was conducted on 193 patients receiving radiotherapy in Oncology Department at Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. One fraction (2 Gray) dose had been given to patients daily for five days in a week and monitor. The collected data was analyzed by applying IBM SPSS v21.Results: The clinical results observed in 193 consecutive patients with follow-up of 7 weeks and graded according to RTOG Acute Radiation Morbidity Scoring Criteria. Majority of events were reported in age group of 41-60 years followed by 61-80 years, 20-40 years. Epidermal, mucosal, Genitourinary and Lower G.I. reactions are graded. The reactions managed by providing symptomatic treatment.Conclusions: Radiation related adverse events have been found frequently in patients with radiotherapy and chemo-radiotherapy both. As the number of doses increase with time the grade of reactions also increases. Appropriate follow-up and management of these events reduces patient burden of treatment.

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.

Recurrence Rates of Dorsal Wrist Ganglion Cysts After Arthroscopic Versus Open Surgical Excision: A Retrospective Comparison

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Matthew W. Konigsberg ◽  
Liana J. Tedesco ◽  
John D. Mueller ◽  
Jacob R. Ball ◽  
Chia H. Wu ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Surgical Excision ◽  
Recurrence Time ◽  
Recurrence Rates ◽  
Lower Recurrence Rate ◽  
Ganglion Cysts ◽  
Cyst Recurrence ◽  
Dorsal Ganglion ◽  
Dorsal Wrist Ganglion

Background This study directly compares the recurrence rates of dorsal wrist ganglion cysts in patients treated via open surgical excision versus arthroscopic surgical excision. We hypothesized that there would be no difference between recurrence rates with these 2 surgical options. Methods We retrospectively reviewed the charts of all patients with a dorsal ganglion cyst undergoing either open or arthroscopic surgical excision at a single academic center with 3 fellowship-trained attending hand surgeons from 2012 to 2017. Charts were identified using Current Procedural Terminology codes and were reviewed using postoperative office notes for preoperative and postoperative symptoms, episodes of recurrence, time at which recurrence occurred, subsequent operations, and outcome at final follow-up. Results The charts of 172 patients undergoing either arthroscopic or open dorsal ganglion excision were reviewed. Nine of 54 (16.7%) arthroscopic excisions resulted in cyst recurrence, while 8 of 118 (6.8%) open excisions resulted in cyst recurrence ( P = .044). Two of 9 (22%) recurrences after arthroscopic ganglion excision versus 2 of 8 (25%) recurrences after open ganglion excision underwent repeat surgical intervention. Time to recurrence, as well as final follow-up, was not statistically different between groups. Conclusions Dorsal wrist ganglion cysts are the most common benign soft tissue mass of the upper extremity, but it remains unknown whether arthroscopic or open surgical excision leads to lower recurrence rate. Scant literature exists directly comparing these 2 methods of surgical excision. This study suggests that open excision of dorsal wrist ganglia leads to a lower recurrence rate than does arthroscopic excision.

scholarly journals Outcome of Surgical Management of Sacrococcygeal Pilonidal Sinus Disease with Rotation Flap in 52 Patients—A Retrospective Study

2021 ◽  
Vol 54 (02) ◽  
pp. 163-167
Author(s):  
Abbas Mistry ◽  
Parvez Shaikh ◽  
Aizaz Mohammed ◽  
Samir Bagasrawala ◽  
Ankit Chauhan ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Suture Line ◽  
Pilonidal Sinus Disease ◽  
Radical Excision ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Rotation Flap ◽  
Post Surgery ◽  
Flap Closure

Abstract Background Surgical treatment of sacrococcygeal pilonidal sinus disease (SPSD) consists of radical excision of the entire tract and treatment of the resultant raw area. Here, the authors have reviewed the results of the rotation flap for closure of the SPSD. Aim This study aims to evaluate the outcomes following SPSD excision and rotation flap closure. Materials and Methods All patients were treated for SPSD with excision and closure using a rotation flap from January 2010 to September 2018. Cases having a follow-up of at least 6 months post surgery were evaluated. Result A total of 52 patients were included in the study; 42 cases were of primary disease while 10 were of recurrent disease. The patients’ follow-up records on the 3rd day, 10th day, 1 month, and 6 months were evaluated.None of the patients showed any signs of recurrence on follow-ups. One patient developed a hematoma on the third day post surgery which was treated conservatively. One patient developed a seroma in the perianal region on the fifth postoperative day which required aspiration. Both these patients healed well subsequently. Conclusion Rotation flap is a (simple and reliable) treatment option for closure of postexcision SPSD defect. It not only takes the tension away from suture line, but also pushes the gluteal fat from the sides into the midline, obliterating the deep crevice of the natal cleft which is believed to be one of the important factors in the causation of SPSD, thus minimizing recurrence.

scholarly journals Minor vs complete excision of pilonidal sinus: Early postoperative period

2012 ◽  
Vol 59 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Jelena Petrovic ◽  
Ivan Dimitrijevic ◽  
Zoran Krivokapic
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Healing Time ◽  
Early Postoperative Period ◽  
Surgical Approaches ◽  
Complete Excision ◽  
Surgical Incision ◽  
Natal Cleft ◽  
Incision And Drainage

Pilonidal sinus arises in the natal cleft of the sacrococcigeal region either as a cyst or as an abscess collection containing hair. It is predominantly a condition of younger people. When presenting as an abscess it usually requires surgical incision and drainage, or bursts spontaneously. In general, there are various surgical approaches to this condition, from very simple to complex ones. Each technique has its supporters and justifications. In the 3 years period, from 2009-2011, 110 treatments of the pilonidal disease were performed on our department. Midline excision was performed in 75 (68.18%) patients and the rest had marsupielisation done. The average discharge time was 1.14 days. Failure to heal occurred in 15 patients (13.63%). During that period we saw recurrence in 4 patients (3.63%). All the patients were coming to our department for postoperative care. The shortest healing time was 4 weeks and longest 21 weeks. During the period may 2011-may 2012 we performed 17 less extensive excisions. All the patients were discharged from the clinic within 23 hours and returned to their daily activities within 5 days. Healing time varied from 2 weeks to 5 weeks. In only one patient with the extensive excision healing time was 8 weeks. Although we had a short follow up period of 11.11 months, we saw no recurrence yet. Our results show that simple individual approach to every patients gives fastest and most comfortable results.

scholarly journals Outcome of Total Laryngectomy in Regional Hospitals of Bangladesh

2021 ◽  
Vol 27 (2) ◽  
pp. 139-144
Author(s):  
M Saiful Islam ◽  
Md Shahjahan Kabir ◽  
Md Abdullah Al Harun ◽  
Md Abdur Razzak ◽  
Mohosana Khanam ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Voice Rehabilitation ◽  
Primary Case ◽  
Medical College ◽  
Regional Hospitals ◽  
Stomal Stenosis

Objectives: To analyze post operative complications, local recurrence, functional outcome of speech & swallowing and survival rate following total laryngectomy. Methods: This prospective observational study was done in four major tertiary care medical college hospitals of Bangladesh from July 2000 to December 2019. All operations were done by a single surgeon, one of the authors of this study based on the personal experience. 45 patients were selected who underwent total laryngectomy for biopsy proven advanced (T3 and T4) laryngeal cancer as primary case & recurrent cases following radiotherapy. Patients were followed up monthly for three months and then six monthly for two years and yearly for rest of their life. Results: Age of the patients ranged from 42 to 80 years with mean age 56.7 years. In postoperative period 03 (6.6%) patients developed wound infection, 03 (6.6%) stomal stenosis, 03 (6.6%) stomal recurrence, 02 (4.4%) seroma, 02 (4.4%) pharyngo-cutaneous fistula and 01 (2.2%) case developed pharyngeal stenosis. In post laryngectomy voice rehabilitation 33 (73.3%) cases used esophageal voice, 07 (15.5%) cases used electrolarynx and 05 (11.1%) cases used bloom singer valve. Out of oesophageal speech, 2 patients had poor speech, Regarding swallowing all patients had very good swallowing except one patient who got pharyngeal stenosis, needed dilation. 3 patients died in subsequent 2 years follow-up and overall survival was 93.3%. Conclusion: Outcome of total laryngectomy depends on site and size of tumour, nodal metastases, recurrent cases and co-existing co-morbidities. Total laryngectomy with or without radiotherapy offers significantly higher local control and survival benefit with advanced laryngeal cancer, compared to radiotherapy only. Bangladesh J Otorhinolaryngol 2021; 27(2): 139-144

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