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 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.

Modified Sinotomy with Marsuplization versus Excision with Lay Open in Treatment of Pilonidal Sinus Disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ashraf Farouk Abdeer ◽  
Amr Mohamed Elhefny ◽  
Wadie Boshra Gerges ◽  
John Sobhy Mamlouk Sawires
Keyword(s):  
Pilonidal Sinus ◽  
Wound Care ◽  
Randomized Study ◽  
Normal Activity ◽  
The Body ◽  
Open Group ◽  
Pilonidal Sinus Disease ◽  
P Value ◽  
Sinus Disease ◽  
Number Of Patients

Abstract Pilonidal sinus disease (PSD) is a common infection of the skin in the gluteal cleft, with a prevalence of 0.7% in the general population. Pilonidal sinus can occur in many different areas of the body but most are found in the sacrococcygeal area, in the natal cleft, approximately 5 cm from the anus. This is a prospective comparative randomized study conducted at Department of General Surgery, Imbaba General Hospital to compare the modified sinotomy with marsupialization versus excision with lay open in treatment of pilonidal sinus disease. Pre-study power analysis revealed that a sample size of 30 patients in each group would be sufficient with 80% power and a P value of 0.05. The perfect approach for the management of PNS should be simple, cause minimal pain, have best chance for success and least recurrence rate with low risk for complications, avoid general anesthesia, require minimal wound care, and ensure minimal inconvenience for the patient with rapid return to normal activity. Number of Patients participated in this study were n = 60 77% of the participants were males aged from 17-52 and 26.3 works as drivers. Operative time in modified sinotomy group ranged from 20-40 minutes and in lay open group ranged from 20-35 min (P-value: 0.07). Presence of hair in the back in the modified sinotomy group in 83.3% while in the lay open group 76.6% (P-value: 0.004). In conclusion, we believe that execution of a minimally invasive surgical technique for PSD can be among the most important methods for treating not only primary PSD but also complicated and recurrent PSD cases.

scholarly journals Use of Silver Nitrate Application as Mini-Invasive Treatment of Pilonidal Sinus Disease

Chirurgia ◽  
2020 ◽  
Vol 115 (6) ◽  
pp. 775
Author(s):  
Burhan Hakan Kanat ◽  
Fatih Mehmet Yazar ◽  
Nizamettin Kutluer ◽  
ozgen Arslan Solmaz ◽  
Mehmet Bugra Bozan ◽  
...  
Keyword(s):  
Silver Nitrate ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Invasive Treatment ◽  
Sinus Disease

Pilonidal sinus disease: Karydakis flap procedure in our patients

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.

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

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.

Intermammary Hidradenitis Suppurativa: Considerations on a Unique Presentation

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.

The current status of surgical pilonidal sinus disease therapy in Germany

2021 ◽  
Author(s):  
Ralph Schneider ◽  
Marius Dettmer ◽  
Nora Peters ◽  
Tenzin Lamdark ◽  
Markus M. Luedi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Current Status ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Disease Therapy

Intra-anal pilonidal sinus disease: a unique diagnosis possibly pointing to the occiput

2016 ◽  
Vol 86 (7-8) ◽  
pp. 622-622 ◽  
Author(s):  
Dietrich Doll ◽  
Verena K. Stauffer ◽  
Markus M. Luedi
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease
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