13- THE ROLE OF PHENOL INJECTION IN THE TREATMENT OF PILONIDAL SINUS DISEASE

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.

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The Role of the Platelet-Rich Plasma in Accelerating the Wound-Healing Process and Recovery in Patients Being Operated for Pilonidal Sinus Disease: Preliminary Results

World Journal of Surgery ◽

10.1007/s00268-009-0046-y ◽

2009 ◽

Vol 33 (8) ◽

pp. 1764-1769 ◽

Cited By ~ 33

Author(s):

Michail Spyridakis ◽

Gregory Christodoulidis ◽

Constantine Chatzitheofilou ◽

Dimitris Symeonidis ◽

Konstantinos Tepetes

Keyword(s):

Wound Healing ◽

Pilonidal Sinus ◽

Platelet Rich Plasma ◽

Healing Process ◽

Pilonidal Sinus Disease ◽

Wound Healing Process ◽

Sinus Disease ◽

Preliminary Results

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Pilonidal sinus disease: Karydakis flap procedure in our patients

Perspectives in Surgery ◽

10.33699/pis.2020.99.8.350-355 ◽

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.

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Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03944-4 ◽

2021 ◽

Author(s):

Christina Oetzmann von Sochaczewski ◽

Jan Gödeke

Keyword(s):

Pilonidal Sinus ◽

Regional Variation ◽

Disease Incidence ◽

Age Groups ◽

Pilonidal Sinus Disease ◽

National Guidelines ◽

Reconstructive Procedures ◽

Sinus Disease ◽

The Mean ◽

Almost All

Abstract Purpose Collective evidence from single-centre studies suggests an increasing incidence of pilonidal sinus disease in the last decades, but population-based data is scarce. Methods We analysed administrative case–based principal diagnoses of pilonidal sinus disease and its surgical therapy between 2005 and 2017 in inpatients. Changes were addressed via linear regression. Results The mean rate of inpatient episodes of pilonidal sinus disease per 100,000 men increased from 43 in 2005 to 56 in 2017. In females, the mean rate of inpatient episodes per 100,000 women rose from 14 in 2005 to 18 in 2017. In the whole population, for every case per 100,000 females, there were 3.1 cases per 100,000 males, but the numbers were highly variable between the age groups. There was considerable regional variation within Germany. Rates of inpatient episodes of pilonidal sinus disease were increasing in almost all age groups and both sexes by almost a third. Surgery was dominated by excision of pilonidal sinus without reconstructive procedures, such as flaps, whose share was around 13% of all procedures, despite recommendations of the national guidelines to prefer flap procedures. Conclusion Rates of inpatient episodes of pilonidal sinus disease in Germany rose across almost all age groups and both sexes with relevant regional variation. The underlying causative factors are unknown. Thus, patient-centred research is necessary to explore them. This should also take cases into account that are solely treated office-based in order to obtain a full-spectrum view of pilonidal sinus disease incidence rates.

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Intermammary Hidradenitis Suppurativa: Considerations on a Unique Presentation

Skin Appendage Disorders ◽

10.1159/000514363 ◽

2021 ◽

pp. 1-4

Author(s):

Ana Luísa João ◽

Nélia Cunha ◽

Joana Cabete

Keyword(s):

Surgical Approach ◽

Inflammatory Disease ◽

Pilonidal Sinus ◽

Hidradenitis Suppurativa ◽

Chronic Inflammatory Disease ◽

Pilonidal Sinus Disease ◽

Sinus Disease ◽

Case Presentation ◽

Overweight Women

Introduction: Hidradenitis suppurativa (HS) is a potentially disabling chronic inflammatory disease. The intermammary location, not clearly specified in the usual phenotypic classifications, entails significant functional and cosmetic compromise. Case Presentation: Eleven cases of predominantly intermammary disease with multiple fistulization and disfiguring scarring were observed at our Department between January 2016 and March 2020. They were young (mean age = 22 years) obese or overweight women, in which the medical-surgical approach has led to variable results. Discussion/Conclusion: Intermammary HS possibly represents a unique phenotypic presentation, likely to be fistulizing and severe. We believe that anatomo-functional considerations, which can be paralleled to pilonidal sinus disease, contribute to its pathophysiology and striking appearance, and further emphasize the importance of multidisciplinary endeavor to reduce the morbidity associated with this seemingly overlooked location.

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