scholarly journals AN UNUSUAL PRESENTATION OF PILONIDAL SINUS – A DIAGNOSTIC CHALLENGE!

2020 ◽  
pp. 1-2
Author(s):  
Rakesh B. S ◽  
Kavya Sivapuram ◽  
Akash Grampurohit ◽  
Sriram Madhan
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Unusual Case ◽  
Histopathological Examination ◽  
Total Excision ◽  
Cell Reaction ◽  
Common Site ◽  
Diagnostic Challenge ◽  
Submandibular Region ◽  
Sacrococcygeal Region

Introduction: Pilonidal sinus (PNS) is any subcutaneous sinus containing hair. 97.8% of PNS are in sacrococcygeal region making it the most common site of PNS. Extrasacrococcygeal PNS accounts for approximately 2.2% of PNS. Few cases of PNS of atypical sites have been reported. The purpose of this paper is to report an unusual case of pilonidal sinus over the submandibular region. Case report: A 36 year old male patient presented with a painless swelling over left side of neck since 2 weeks which on examination had no tenderness and no local raise of temperature. Ultrasonography of neck was suggestive of abscess. Excision of the swelling was done and histopathological examination showed chronic inflammation with foreign body gaint cell reaction suggesting diagnosis of Pilonidal sinus. Conclusion: Pilonidal sinus over submandibular region is unusual and a diagnostic challenge. Total excision and primary closure was done in this case.

scholarly journals Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus disease in the pediatric population

2018 ◽  
Vol 53 (10) ◽  
pp. 2003-2007 ◽  
Author(s):  
Joana Barbosa Sequeira ◽  
Ana Coelho ◽  
Ana Sofia Marinho ◽  
Berta Bonet ◽  
Fátima Carvalho ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pediatric Population ◽  
Pilonidal Sinus Disease ◽  
Total Excision ◽  
Sinus Disease

scholarly journals Intermammary pilonidal sinus: rare location of a common condition

2020 ◽  
Vol 8 (1) ◽  
pp. 385
Author(s):  
Gayatri A. Deshpande ◽  
Raj N. Gajbhiye ◽  
Bhupesh Tirpude ◽  
Hemant Bhanarkar ◽  
Vikrant Akulwar ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Histopathological Examination ◽  
Skin Surface ◽  
Sinus Tract ◽  
Complete Excision ◽  
Rare Location ◽  
Keloid Formation ◽  
One Year

Pilonidal sinus in the intermammary region is a rare location of an inflammatory condition commonly occurring in the natal cleft. It is typically characterised by a pus and hair containing cavity in the skin lined by granulation tissue connecting the skin surface. A 22 year-old female presented with chronically discharging sinuses in the intermammary region with recurrent abscess formation for one year duration. Although a rare location, clinical diagnosis of pilonidal sinus was made. Complete excision of sinus tract with abscess cavity with primary closure was performed under general anaesthesia. Histopathological examination confirmed pilonidal sinus. On follow up, the scar was healthy with no keloid formation. Pilonidal sinus may rarely occur in intermammary region. Complete excision and primary closure is the mainstay treatment.

scholarly journals Comparison between the tie-over and Karydakis procedure in chronic sacrococcygeal pilonidal sinus

2021 ◽  
Vol 23 (2) ◽  
pp. 56-61
Author(s):  
Mohammad Moazeni Bistgani
Keyword(s):  
Patient Satisfaction ◽  
Pilonidal Sinus ◽  
Wound Repair ◽  
Primary Closure ◽  
Postoperative Morbidity ◽  
Surgical Excision ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Therapeutic Modalities ◽  
Sacrococcygeal Region

Background and Aims: Pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort for the patient. Although there are various therapeutic modalities to manage these patients, Controversy for choosing the best surgical technique in order to decrease the recurrence rate, patient discomfort, and Duration of disability after surgery still exists. Therefore, the objective of the present study was to compare results reached from two methods of surgery, tie-over procedure (TOP) and Karydakis procedure(KP) for the treatment of sacrococcygeal pilonidal sinus. Methods: In this study, 70 patients with a diagnosis of pilonidal sinus disease treated randomly with surgical excision and TOP or KP, in two 35 patients group, in the educational hospital by the same surgeon, between 2009 and 2010, and followed up until December 2019. Results: Achieved data after excision of sacrococcygeal pilonidal sinus indicate that primary closure of the wound by tie-over sutures have a better result than KP in order of Pain sore during the first month after surgery (P< 0.001), Duration of disability (P <0.001), wound repair time (P <0.001) and Patient satisfaction(P=0.019). Conclusion: Overall, these results show the TOP instead of KP, because higher acceptance results may be an alternative better for the treatment of chronic pilonidal sinus for the patients who have surgery scheduled for them.

Management of Pilonidal Sinus (Nadi Vrana) with Palasha Kshara Sutra prepared in Arka Ksheera - A Case Study

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Leena Naik ◽  
Ganapathi Rao ◽  
Ashok Naikar ◽  
Jyothi Rajole
Keyword(s):  
Minimally Invasive ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Risk Of Recurrence ◽  
Young Males ◽  
Chronic Disorder ◽  
Sacrococcygeal Region ◽  
Surgical Methods

Pionidal Sinus is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Different surgical methods have been described for this disorder. The most commonly used are excision and primary closure and excision with reconstructive flap. However the risk of recurrence or developing an infection of the wound after the operation is high. The patient requires longer hospitalization and the procedure is expensive. There is a similarity between pilonidal sinus and Shalyaja Nadi Vrana described in Susruta Samhita. Susruta has advocated a minimally invasive parasurgical treatment, viz., Kshara Sutra procedure, for Naadivrana. Hence this procedure was tried in Pilonidal Sinus. This treatment not only minimizes complication and recurrence, but also enables the patient to resume work quicker and with less discomfort.

scholarly journals Pilonidal sinus of the cheek: an extremely rare clinical entity—case report and brief review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
B. N. Adhikari ◽  
S. Khatiwada ◽  
A. Bhattarai
Keyword(s):  
Pilonidal Sinus ◽  
Histopathological Examination ◽  
Suture Line ◽  
Interesting Case ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Complete Excision ◽  
Case Presentation ◽  
Sacrococcygeal Region ◽  
Rule Out

Abstract Background Pilonidal sinus is commonly seen at the sacrococcygeal region and few other sites, usually located at the midline, at areas where hairs collect or near protuberances or some adjacent rubbing surfaces. Its presence elsewhere is uncommon. We share an interesting case of a recurrent discharging sinus from the cheek bulge of a male which turned out to be a pilonidal sinus containing tuft of hairs on exploration and wide excision. Case presentation A 37 years old hirsute male presents to us with a non-healing discharging sinus at the bulge of the cheek. Exploration after a course of antibiotics showed 2 subcutaneous cavities with tuft of hairs. The area was excised along with a margin, thorough irrigation and curettage was done and the wound was closed primarily; a Z-plasty was incorporated in the central part to break the resultant suture line. Histopathological examination was done to confirm the diagnosis and rule out an off-midline dermoid cyst or an underlying/coexisting malignancy. Post-operative course was uneventful. The patient has been recurrence free for 1.5 years and is satisfied with the nature of the scar. Conclusions Pilonidal sinus of the cheek bulge is an extremely rare entity. Complete excision and clinical suspicion are important for cure of this nagging ailment, especially at unexpected areas.

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.

scholarly journals Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence

2012 ◽  
Vol 97 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Akin Onder ◽  
Sadullah Girgin ◽  
Murat Kapan ◽  
Mehmet Toker ◽  
Zulfu Arikanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Disease Risk ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Faculty Department ◽  
Closure Method

Abstract The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P  =  0.039). Regarding recurrence, family tendency (P  =  0.011), sinus number (P  =  0.005), cavity diameter (P  =  0.002), and primary closure (P  =  0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.

Compare outcome of simple excision with primary closure vs rhomboid excision with limberg flap for pilonidal sinus

2021 ◽  
pp. 2920-2922
Author(s):  
M. Kaleem ◽  
F. Mubarik ◽  
M. U. Afzal ◽  
A. Zahid ◽  
W. I. Andrabi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
P Value ◽  
Limberg Flap ◽  
Simple Excision ◽  
Group A ◽  
Group B ◽  
Rhomboid Excision

Background: Sacrococcygeal pilonidal sinus is a common condition usually affecting young-to-middle-aged men. For managing sacrococcygeal pilonidal illness, a variety of lateralizing surgical flap procedures based on this principle have been published, including the Karydakis flap, Limberg flap, modified Limberg flap, Z-plasty, and Y-V advancement flap. Aim: To compare the outcome of simple excision with primary closure versus rhomboid excision with limberg flap for sacrococcygeal pilonidal sinus. Methodology: Randomized control study conducted in Surgery Department, Ghurki Trust Hospital, Lahore. 90 patients fulfilling the inclusion criteria were selected from wards and were randomly divided in two equal groups. In group A, patients underwent rhomboid excision with limberg flap. In group B, patients underwent simple excision with primary closure. The operation was performed under spinal anesthesia. After surgery, patients were evaluated every 24 hours if they are able to move on their own then they were discharged and hospital stay was noted. Then after 10 days, patients will be called in OPD for assessment of wound healing. If wound did heal and patient complained of pain (VAS>4) and cannot sit and have fever (temp>100oF) Results: The average age in group A was 44.37±15.42 years while that in group B was 45.24±14.50 years. In group A there were 23(51.1%) males and 22 (48.9%) females whereas in group B there were 25(55.6%) males and 20(44.4%) females. There was difference significant in the mean stay in hospital in both groups (p-value=0.002). Conclusion: The conclusion of the study, that primary sacrococcygeal pilonidal sinus disease and rhomboid excision with Limberg's flap is an effective treatment. Keywords: Simple Excision with Primary Closure, Rhomboid Excision, Limberg Flap, Sacrococcygeal Pilonidal Sinus

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