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.

A Review on Salyajanya Nadi Vrana (pilonidal sinus) with clinical approach

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Rajasree G. ◽  
Anita K. Patel
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Common Disease ◽  
Clinical Approach ◽  
Natal Cleft ◽  
Surgical Interventions ◽  
Male Predominance ◽  
Ayurvedic Treatment ◽  
Treatment Aspect

A Pilonidal Sinus is a common disease of the natal cleft. Pilonidal Sinus is a track which containing hairs. The incidence of the disease is calculated to be 26 per 100,000 people. Pilonidal disease has a male predominance 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 application of Kshara (caustic alkali) and Ksharasutra (Seton) in the management of Nadivrana. Studies shows that by Ayurvedic treatment, it helps to reduce recurrence rate, even though Nadivrana is said to be Kricchrasadhya (difficult to cure). Hence sucessful management of this disease depends on the knowledge of pathogenesis, patients presentation and knowledge on treatment aspects.

scholarly journals Management of pilonidal sinus disease with Limberg flap: our experience

2020 ◽  
Vol 7 (5) ◽  
pp. 1575
Author(s):  
Mahavir Singh ◽  
Saish Dalal ◽  
Baleshwar . ◽  
Sethu Raman
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Pilonidal Sinus Disease ◽  
Common Disease ◽  
Main Concern ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Minimal Scarring ◽  
Early Return

Background: Pilonidal sinus disease is a common disease of young adults. The management of the sacrococcygeal pilonidal sinus varies from conservative measures to various surgical procedures. The main concern for the treatment to the patient is the recurrence. Although several methods have been described all have been associated with high recurrence rates. This study was carried out to evaluate the advantages, results of rhomboid excision and limberg flap reconstruction in the management of pilonidal sinus disease.Methods: This prospective study was conducted in General Surgery department of a tertiary care centre of Haryana. It includes 29 patients who were treated for pilonidal sinus disease by Limberg flap surgery from January 2015 to January 2019.  Results: All patients were successfully treated with minimal postoperative discomfort. Only two patients developed seroma which was managed conservatively and in two patients there was slight flap tip necrosis which was also managed conservatively. Rest all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no recurrence so far.Conclusions:Limberg flap is very effective treatment for pilonidal disease. It has many advantages as it is easy to perform and design, and it flattens the natal cleft with large vascularized pedicle, sutured without tension. This in turn maintains good hygiene, reducing the friction, preventing maceration, and avoiding scar in the midline. The technique is easy to perform in quick time, useful in both primary and recurrent diseases, with very low complication and recurrence rate. Other advantages are quick healing time, short hospital stay, and early return to daily life.  

scholarly journals LASER ABLATION FOR PILONIDAL DISEASE

2020 ◽  
Vol 19 (2) ◽  
pp. 91-103
Author(s):  
D. A. Khubezov ◽  
R. V. Lukanin ◽  
A. R. Krotkov ◽  
A. Y. Ogoreltsev ◽  
P. V. Serebryansky ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Main Group ◽  
Cosmetic Result ◽  
Control Group ◽  
Primary Wound Closure

AIM: to evaluate short-term results of pilonidal disease treatment using different methods: the excision of pilonidal sinus and fistula with open wound healing, the primary closure of the wound and the laser ablation (2017-2019).PATIENTS AND METHODS: ninety patients with pilonidal disease without abscess were included in the comparative non-randomized study. The control group included 30 patients with excision and open wound healing. The first main group included 30 patients with the excision of pilonidal sinus and fistula with primary wound closure. The second main group included 30 patients with laser ablation of pilonidal sinus and fistula. The evaluation criteria included gender, age, BMI, number of previous procedures, operative time, hospital stay, postoperative pain intensity (VAS), cosmetic result (VAS), complication rate and recurrence rate.RESULTS: all three groups were homogeneous in gender, age, BMI. The control group showed no complications (р<0.0001) and no recurrence (р<0.0001) rate but had more intensive pain (mean 5.9 points; р<0.0001) and worse cosmetic result (mean 4.4 points; р<0.0001). The group with primary wound closure (1st main group) had the highest complication rate (23.4%; р=0.004) and recurrence rate (16.7%; р=0.02). The group with laser ablation had significantly shorter hospital stay (1.1 days; р<0.0001), good cosmetic result (mean 8.9 points; р<0.0001) and less postoperative pain (1.4 points; р<0.0001) with low recurrence rate (3.3%; p=0.32).CONCLUSION: the laser ablation of pilonidal sinus and fistula provides less postoperative pain intensity and low recurrence rate, better cosmetic result and short hospital stay. It can be used for outpatient treatment.

A Comparative Clinical Study on Phalatrikadi Kwata and Darvyadi Kwatha in the management of Kamala w.s.r. to Jaundice

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Kallanagouda H. ◽  
S. C. Sarvi
Keyword(s):  
Clinical Study ◽  
Dietary Habits ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Mucous Membranes ◽  
Comparative Clinical Study ◽  
Group A ◽  
Clinical Signs And Symptoms ◽  
Ayurvedic Treatment ◽  
Group B

Background: Jaundice (Kamala) is a yellowish pigmentation of the skin, the conjunctival membranes over the sclera (whitish of the eyes), and other mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). Today’s lifestyle with unhygienic and poor dietary habits and alcoholic habits etc. are responsible factors to promote hepatic damage which clinically reflects as Kamala Roga. The incidence of such causes resulting in Jaundice. In India it is 2.37-3.15 per 1000 population. The effect of Ayurvedic treatment was assessed in relation to improvement in overall clinical signs and symptoms. Objectives: To evaluate the effect of Phalatrikaadi Kwatha and Darvyadi Kwatha in Kamala Roga. Methodology: A comparative clinical study was conducted on Kamala for period of 15 days. The patients were divided into 2 groups. In Group A 20 patients were administered with Phalatrikadi Kwatha internally and in Group B 20 patients were administered with Darvyadi Kwatha internally. Results: Group A and Group B have shown statistically significant result. Group B treated with Darvyadi Kwatha showed better result compared with Group B treated with Phalatrikadi Kwatha.

scholarly journals Kshar sutra in Pilonidal sinus: a minimal invasive modality of management

2017 ◽  
Vol 4 (2) ◽  
pp. 834
Author(s):  
Murtaza Akhtar ◽  
Himanshu Gupta ◽  
Sunil Mishra ◽  
Murtuza Rangwala ◽  
Anil Kad
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Case Series ◽  
Minimal Invasive ◽  
Care Hospital ◽  
Duration Of Treatment ◽  
Entire Treatment Period ◽  
Natal Cleft ◽  
Septic Focus

Pilonidal sinus is an infective condition between the natal cleft in young males. Chronic Pilonidal disease normally needs a surgical treatment for eradication of septic focus, which ranges from cutting of the tract to complex rotation flap. Kshar sutra is an age old treatment modality practiced since times of Sushruta. Lack of established evidence in the evidence based scenario is the rationale for current study. It is a tertiary care hospital based case series with inclusion criteria of pain and discharge in and around the natal cleft. Clinically diagnosed as Pilonidal sinus with two openings one in natal cleft and other outside the natal cleft. The patients with multiple sinuses, previous treatment and co-morbid conditions are excluded. The study factor was of Kshar sutra threading of Pilonidal Sinus done under local infiltration of anaesthesia around the tract and changed 2-3 times during entire treatment period on clinical judgement. The outcome factors were duration of cutting open of tract and duration for total healing, number of times Kshar sutra was changed and local complications. A total of 5 cases, all males with median age of 21 years and median presentation duration of 8 months were recruited. The median cutting duration of the tract was 23 days and total tract healing time was 29 days. Kshar sutra was changed 2-3 times during the entire duration of treatment. There was no post-operative complication and recurrence after 20.4 months of follow up. Kshar sutra is a minimal invasive procedure in Pilonidal sinus which has encouraging results but need large sample and an RCT to provide quality evidence.

scholarly journals Pilonidal sinus disease: Case report and review of the literature

2018 ◽  
Vol 23 (2) ◽  
pp. 86-88
Author(s):  
Olayinka A. Olawoye ◽  
Izegaegbe O. Obadan ◽  
Joshua D. Choji
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Surgical Interventions ◽  
Hygiene Measures ◽  
Disease Case ◽  
History Of ◽  
Subcutaneous Tissues ◽  
High Index Of Suspicion

Pilonidal sinus disease is a chronic granulomatous condition resulting from the presence of hair in the subcutaneous tissues. Its treatment ranges from simple hygiene measures to complex surgical interventions depending on the mode of presentation. We present a 59-year-old man who had a history of re-current swelling in the left gluteal region of about 2 years duration. After a diagnosis was made of pilonidal sinus disease, he had open surgery with laying open of the sinus and exploration with a probe in the operating room under local anesthesia. The sinus measured about 4 cm. He had drainage of the sinus cavity with curettage of the floor of the sinus. Pilonidal sinus disease may not be as uncommon in our setting as previously thought. A high index of suspicion should be entertained based on the characteristic location and typical presentation of the condition. Keywords: pilonidal sinus; pilonidal disease; pilonidal cavity 

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 EFFECTIVENESS OF GLUTEUS MAXIMUS FASCIA PLASTY FLAP FOR CLOSURE OF WOUND IN SURGICAL TREATMENT OF PILONIDAL DISEASE

2018 ◽  
Vol 24 (5) ◽  
pp. 233-236
Author(s):  
Yury E. Kitsenko ◽  
D. D Shlyk ◽  
I. A Tulina ◽  
D. R Markaryan ◽  
P. V Tsarkov
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Operation Time ◽  
Gluteus Maximus ◽  
Long Term Results ◽  
Midline Closure ◽  
Fascia Flap

Aim: to compare short- and long-term results of primary midline closure and gluteus maximus fascia flap plasty after pilonidal sinus excision. Method: retrospective analysis included consecutive patients who had primary and recurrent pilonidal sinus excised. Patients with gluteus maximus fascia flap plasty formed 1st group, patients with primary midline closure formed 2nd group. Gluteus maximus fascia flap plasty technique: (i) separation in lateral directions of both gluteus maximus fascia from muscle and subcutaneous tissue; (ii) mobilised fascia flaps are brought together to midline and sutured; (iii) subcutaneous fat and skin sutured. Results: 60 patients operated in 2007-2016 were included: 28 in 1st group, 32 in 2nd group. Groups 1 and 2 didn’t differ in operation time (41.9±4.0 and 37.3±3.1 min, p=0.4), blood loss (6.9±0.5 and 8.3±1.6 ml, p=0.2), draining rate (7.1% and 12.5%, p=0.5), hospital stay (11.8±1.3 and 9.1±1.0 days, p=0.1), time to complete wound epithelialization (1.2±0.2 and 1.5±0.4 months, p=0.37). Mean follow-up was 20.7±3.2 and 53.8±6.5 months respectively. Recurrence rate was significantly lower in gluteus maximus fascia flap plasty group (3.6%) than in the 2nd group (21.9%, p=0.04). Conclusion: gluteus maximus fascia flap plasty after pilonidal sinus excision is feasible, doesn’t increase postoperative complications rate and leads to a lower recurrence rate compared to midline closure.

scholarly journals Study of clinical profile, surgical interventions and outcome in a series of patients with pilonidal disease

2019 ◽  
Vol 6 (12) ◽  
pp. 4512
Author(s):  
Kailash K. Jawade ◽  
Vaishali Radhakishan Bande
Keyword(s):  
Young Adults ◽  
Promising Result ◽  
Pilonidal Disease ◽  
Complete Excision ◽  
Benign Condition ◽  
Natal Cleft ◽  
Surgical Interventions ◽  
Operative Recovery ◽  
Rhomboid Flap ◽  
Age Range

Background: Pilonidal disease is a controversial benign condition that often causes nuisance and disability in young adults. Sacrococcigeal region, intergluteal natal cleft, interdigital cleft in barbers and the other hair bearing areas like axilla are found to be involved. Different authors have described different techniques of management of pilonidal disease.Methods: During September 2010 to August 2018 total 24 patients were presented with pilonidal disease and were treated using various surgical interventions. This retrospective study is done to study demographics and clinical spectrum, clinical course, outcome of different surgical interventions done and complications associated with various techniques.Results: Out of 24 patients 18 (75%) were males whereas 6 patients (25%) were females. The age range was 23 to 44 years. Sacrococcigeal region is the most commonly affected region in this series. In this series average duration of presence of pilonidal disease before presentation was 89 days ranging from 4 days to 168 days. One of 24 patients was treated with medical management and rest 23 patient required surgical intervention. Complete excision with rhomboid flap was the most common way of treating pilonidal disease and was used in 10 (41.6%) cases.Conclusions: Pilonidal disease is benign condition seen in young adults associated with morbidity without any mortality. Sinus is the commonest mode of presentation and sacrococcigeal region is the commonest site affected by this disease. Rhomboid flap has a promising result in terms of less post-operative recovery time and post-operative complications. 

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