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Results for “Pilonidal Sinus”

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PubMed2002

Laser depilation of the natal cleft--an aid to healing the pilonidal sinus.

BACKGROUND: Pilonidal disease is common. Excessive hair growth in the natal cleft is thought to be a factor in initiating these sinuses. It is chronic and intermittent in nature and treatment can be difficult. Hair removal by shaving or use of creams is often advised as a compliment to surgical treatments. However, access to the natal cleft can be difficult. Laser removal of hair in the natal cleft is considered as an aid to healing the pilonidal sinus. PATIENTS AND METHODS: Over a 5-year period, 14 patients with recurrent pilonidal disease were treated in our unit with laser depilation. They were all contacted by postal questionnaire, and those with ongoing disease were asked to return to the clinic for evaluation and possible further treatment. RESULTS: All patients returned the postal questionnaire. Of the 14 patients, 4 had on-going disease and received further depilation with the Alexandrite laser. All are now healed with no reported complications. All patients found the procedure painful and received local anaesthetic. CONCLUSIONS: Laser depilation in the natal cleft is by no means a cure for pilonidal disease. Removal of hair by this method represents an alternative and effective method of hair removal and, although long lasting, is only temporary. However, it allows the sinuses to heal rapidly. It is relatively safe, and simple to teach, with few complications. It should thus be considered as an aid to healing the problem pilonidal sinus.

Adolescent↗
PubMed2002

Gluteal V-Y advancement fasciocutaneous flap for treatment of chronic pilonidal sinus disease.

Although pilonidal disease is quite common, controversy still exists about the treatment. The procedure should cure the patient, and allow speedy resumption of normal activities by reducing pain and disability. This retrospective study was conducted to evaluate our experience with the V-Y fasciocutaneous advancement flap and to review current publications about flap surgery for the treatment of sacrococcygeal pilonidal sinus. We describe the application of the fasciocutaneous V-Y advancement flap for reconstruction of defects after radical excision of recurrent pilonidal sinus in 11 cases. Primary and uneventful wound healing was achieved in all patients but two who developed minor wound breakdown. Large defects after excision can easily be closed using the V-Y advancement flap. This type of flap closure in selected cases offers tension-free, recurrence-free, and reliable skin coverage while flattening the natal cleft that predisposes to recurrences. Reliable flap closure reduces hospital stay, costs, as well as disability and time spent off work.

Adult↗
PubMedDate not supplied

Perineal pilonidal sinus. Case report.

Pilonidal sinus is a very common disease and its most frequent location is in the presacral area. Other locations are extremely rare. We describe the case of a 28-year-old white man, a baker by profession, with a swelling around the right side of the anus, pain with burning, itching and seropurulent secretion which had been present for 7 months. A physical examination demonstrated the presence of multiple cutaneous fistulas. A fistulography and the endoscopy demonstrated the absence of fistulas-in-ano. Moreover, MRI confirmed the diagnosis of a perianal mass not communicating with the anal canal. Surgical exploration revealed the presence of hair and an excision of the mass with fistulas was performed. Healing was rapid and uncomplicated. Perineal pilonidal sinus with foreign body inflammatory reaction was the histological diagnosis.

Adult↗
PubMed2001

Sacral adipofascial turn-over flap for the excisional defect of pilonidal sinus.

The aim of pilonidal sinus surgery includes complete resection of the lesion and filling of the resultant soft-tissue defect by some means; this has a major influence on whether a lesion will occur after surgical treatment. The creation of a sacral adipofascial turn-over flap for the excisional defect has been performed in seven cases of pilonidal sinus since November of 1992. During the postoperative follow-up period, which ranged from 10 months to 7 years 11 months (mean duration, 5 years 2 months), partial dehiscence of the wound as a result of fatlysis was observed and treated conservatively in one case; however, primary healing was obtained in the other cases. No recurrence was seen in any of the seven cases. This procedure is not indicated in patients in whom wide skin resection is required because of the excessive tension associated with skin closure in such cases. However, the method is convenient, less invasive, and reliable, and therefore considered to be useful in the treatment of pilonidal sinus.

Adipose Tissue↗
PubMedDate not supplied

Drainage useful in the excision and closure "per primam" of pilonidal sinus: technical notes.

Pilonidal sinus treatment is still controversial, since all the most commonly used methods cause the patients considerable discomfort ("open" method) or increase the recurrence rate ("closed" method). In view of this, we reviewed our series of 52 patients treated by "en bloc" excision of all pathological tissue following closure "per primam" of the wound, after applying an aspirating drainage, which was then removed on day 2 or 3. Routine use of the drainage, antibiotic prophylaxis continued until postoperative day 6 or 7 and thorough daily disinfection of the wound and its neighbouring skin until removal of the suture, enabled us to achieve encouraging results (slight complications in 3 cases and only one recurrence).

Female↗
PubMed2000

[The Limberg transposition flap in surgical therapy of chronic pilonidal sinus].

The operative treatment of pilonidal sinus is characterized by an increased rate of wound healing complications and late recurrences. The Limberg transposition flap is an easy method for covering the defect after excision of the pilonidal sinus. The flap smooths out the deep skin fold of the rima ani and counteracts in this manner an important pathogenetic factor of pilonidal sinus recurrence. Between 6/96 and 7/99 we treated 42 patients using this method without complications of wound healing or recurrences. Comparison of literature results of different operative treatments (open granulation, primary suture, Z-plasty) shows lessened complication and recurrence rates for the Limberg transposition flap, which is the method of choice for chronic pilonidal sinus nowadays.

Abscess↗
PubMed2003

Vacuum-assisted closure of a complex pilonidal sinus.

INTRODUCTION: The annual incidence of pilonidal sinus is approximately 26 per 100,000, of which complex pilonidal sinuses are the minority. Many different approaches have been described for managing simple cases. Treatment options for complex pilonidal sinus include excision with healing by secondary intention or plastic surgical procedures to obliterate the defect. Recently, vacuum-assisted closure has been used by plastic surgeons to facilitate healing of chronic or complicated wounds with particular success in treating pressure wounds overlying the sacrum. METHODS: A patient with a complex pilonidal sinus was managed with excision and vacuum-assisted closure. RESULTS: A large tissue defect after radical excision healed relatively quickly when the subatmospheric pressure dressing was applied. The patient was discharged with the vacuum pump and change of dressings for alternate days. CONCLUSION: Vacuum-assisted closure of a complex pilonidal sinus shortened the length of hospital stay and the need for further surgery and provided a cosmetically acceptable result.

Adult↗
PubMed2005

Umbilical pilonidal sinus disease: predisposing factors and treatment.

Pilonidal sinus disease is a common problem of sacrococcygeal region. However, it is also observed in the periumbilical area. There are only a few reports about umbilical pilonidal sinus in the literature. In this study, 26 patients (24 men (92 %), 2 women (8 %) with a mean age of 22 years) with umbilical pilonidal sinus disease were included. Predisposing factors, patient characteristics, treatment modalities, and their results have been studied. Male sex, young age, hairiness, deep navel, and poor personal hygiene were found to be predisposing factors. Twenty-five patients were treated conservatively. However, two patients failed to respond to conservative treatment. Those patients underwent surgery where umbilectomy was carried out without reconstruction. One patient was also operated on for the preoperative misdiagnosis of irreducible umbilical hernia. Patients were followed for 14-96 months. We recommend conservative treatment in patients with umbilical pilonidal sinus. Surgery should be performed in recurrent cases resistant to conservative treatment. The importance of differential diagnosis of umbilical pilonidal sinus from other umbilical pathologies is also emphasized.

Adolescent↗
PubMed1998

Umbilical pilonidal sinus.

Although most cases of pilonidal sinus occur in the sacrococcygeal region, umbilical presentations can occur. Due to risk of peritoneal extension of inflammation from this lesion, the umbilical pilonidal sinus should be treated more aggressively than its sacrococcygeal counterpart. Pilonidal sinus should therefore be included in the differential diagnosis of umbilical nodules.

Adult↗
PubMed2002

[Results of the Limberg transposition flap in the treatment of pilonidal sinus].

The surgical treatment of pilonidal sinus with the Limberg transposition flap will be demonstrated in 40 patients (22 male; 18 female). First step is draining the infect by incision, followed by radical excision of the pilonidal sinus and covering of the defect by a rhomboid transposition flap. In 39 out of 40 cases primary wound healing occurred. No recurrence has yet been encountered. In one case a seroma was observed which was drained and showed secondary wound healing. The mean hospital stay was 7.9 days and the mean time until return to work was about 15 days. We consider the Limberg transposition flap to be an effective treatment of pilonidal sinus disease due to its technical simplicity and low complication rate.

Abscess↗
PubMed1995

The origin of pilonidal sinus: a case report.

The etiology of pilonidal sinus remains controversial. Some think it is congenital, and others think it is acquired. It is difficult to distinguish acquired pilonidal sinus from congenital, because infection almost always complicates both. We report here one case of acquired pilonidal sinus unaccompanied by infection. Histological examination showed that no epidermis or hair follicle was present in the inner wall of the sinus. This case shows that acquired pilonidal sinus is due to invasion of external hairs and that this condition needs to be distinguished from congenital pilonidal sinus.

Adult↗
PubMed2006

Day-care surgery for pilonidal sinus.

INTRODUCTION: The surgical approach to symptomatic pilonidal sinus is open to debate. Many techniques have been described and no single technique fulfils all the requirements of an ideal treatment. Ambulatory treatment with minimal morbidity and rapid return to activity is desirable. The aim of this work was to study the feasibility of day-care surgery for excision and primary asymmetric closure of symptomatic pilonidal sinus. PATIENTS AND METHODS: All patients referred electively over 2 years were assessed in a single-consultant, colorectal clinic and booked for day-care surgery. All patients had excision and primary asymmetric closure under general anaesthesia in the left lateral position. Whenever possible, they were discharged on the same day according to the day-surgery protocol. Patients were subsequently seen in the out-patient clinic for removal of stitches and were followed up further if there was any wound breakdown. RESULTS: Fifty-one patients were operated on electively for pilonidal sinus over the 2 years. Two patients were excluded as the final diagnosis was not pilonidal sinus. At 4 weeks following operation, 43 (88%) had complete healing and 6 (12%) had dehiscence of the wound. Recurrence rate was 8% (4 patients) for follow-up of 12-38 months. There was no admission from the day-surgery unit and no unplanned re-admissions. The cost for day-care pilonidal sinus surgery was estimated to be 672.00 pounds per patient compared with in-patient cost of 2405.00 pounds. CONCLUSIONS: Excision and primary asymmetric closure for pilonidal sinus is safe and feasible as day-care surgery and is associated with potential cost saving.

Adolescent↗
PubMed2006

Comparative study between radiofrequency sinus excision and open excision in sacro-coccygeal pilonidal sinus disease.

AIM: Evaluation of outcome of pilonidal sinus excision using a radiofrequency device and comparing its results with excision and open granulation procedure. METHODS: Patients with sacro-coccygeal pilonidal sinus disease (n=44) were randomly assigned to undergo either a wide excision and healing by open granulation procedure [WEG] (n=23) or a radiofrequency sinus excision [RSE] (n=21). An Ellman radiofrequency generator was used for RSE. Intra- and postoperative events and outcome data were evaluated and analyzed by Student's unpaired t test and chi(2) test. RESULTS: The significant differences in the two groups WEG and RSE were as follows: mean hospital stay (47 vs. 10 h, p< 0.05), period off work (29 vs. 8 days, p< 0.05), mean analgesic requirement (39 vs. 15 tablets, p< 0.05), time for complete wound healing (84 vs. 49 days, p< 0.05). At the mean follow-up of 30 months, 2 patients from the wide excision and open granulation group and one patient from the radiofrequency sinus excision group developed recurrence. CONCLUSION: These findings suggest that sinus excision with radiofrequency is a simple and swift procedure. It needs a short hospital stay and is associated with less postoperative pain and early resumption to work. As compared to excision and healing by granulation technique, the radiofrequency sinus excision procedure achieves faster wound healing and a better outcome.

Adult↗
PubMed2001

Lack of evidence that obesity is a cause of pilonidal sinus disease.

OBJECTIVE: To find out whether pilonidal sinus is more common among obese people. DESIGN: Retrospective study from hospital records. SETTING: Two university hospitals, Turkey. SUBJECTS: 419 patients who were operated on for pilonidal sinus disease; and 213 age and sex matched patients with benign diseases other than pilonidal sinus disease and who were not morbidly obese acted as controls. MAIN OUTCOME MEASURES: Comparison of body mass index (BMI) in the two groups. RESULTS: Patients with BMI of 25-30 were classified as overweight (61/419, 15% compared with 28/213, 13%), and those with BMI of 30 or more as obese (7/419 compared with 4/213, 2% in each group). Mean (SD) BMI of patients with pilonidal sinus disease was 26.0 (3.9) compared with 25.6 (3.9) in the control group (p = 0.4). CONCLUSION: Obesity alone is not an important factor in the aetiology of pilonidal sinus disease.

Adolescent↗
PubMed1999

Incidence and aetiological factors in pilonidal sinus among Turkish soldiers.

OBJECTIVE: To study the incidence and causes of pilonidal sinus in Turkish soldiers. DESIGN: Open study by questionnaire. SETTING: Military and University hospitals, Turkey. SUBJECTS: 1000 soldiers who presented for their first medical examination. MAIN OUTCOME MEASURES: Correlation between factors known to be associated with pilonidal sinus, and incidence of pilonidal sinus. RESULTS: 88/1000 soldiers had pilonidal sinuses; in 48 they were symptomatic and in 40 asymptomatic. The factors associated with the presence of a pilonidal sinus were: family history of pilonidal sinus (18/88 compared with 32/912, p < 0.0001); obesity defined as weight over 90 kg (34/88 compared with 32/912, p < 0.0001); being the driver of a vehicle (58/88 compared with 308/912, p < 0.0001); and the incidence of folliculitis or a furuncle at another site on the body (22/88 compared with 64/912, p < 0.0001). CONCLUSIONS: Pilonidal sinus is an acquired condition, penetration of hair is the main cause, and the disease can be prevented if the aetiological factors are understood.

Adult↗
PubMed2005

Radiofrequency sinus excision: better alternative to marsupialization technique in sacrococcygeal pilonidal sinus disease.

BACKGROUND: A number of techniques have been described for treatment of patients with sacrococcygeal pilonidal sinus disease. The author reports his experience in the surgical management of pilonidal sinus using radiofrequency sinus excision technique. The results are compared with those obtained after excision and marsupialization procedure. MATERIALS AND METHODS: Seventeen patients were operated by radiofrequency sinus excision and 18 with excision and marsupialization. An Ellman radiofrequency device was used. The two groups were matched for age, gender and presentation symptoms. The median follow-up was two years. The patient's satisfaction on the outcome of the procedure was also evaluated. RESULTS: In the radiofrequency sinus excision group, we found on average a shorter operation time (10 vs. 36 minutes, p < 0.001), shorter hospitalization (nine vs. 30 hours, p < 0.001), significantly less postoperative pain, fewer cumulatve requests for analgesia by the patients (14 vs. 25 tablets, p < 0.001), and earlier return to work (six vs. 16 days, p < 0.001) The wounds with marsupialization did heal faster than those with sinus excision; however, the difference was not significant. At two year follow-up, one patient from each group had a recurrence. CONCLUSION: This pilot study shows that this new technique can be performed as a day care surgery. With reduced postoperative pain and early resumption to work, patient satisfaction is better in comparison to excision and marsupialization technique.

Adolescent↗
PubMed2006

Pilonidal sinus of the neck.

A pilonidal sinus is most commonly seen in the sacrococcygeal region. Here we describe a rare case of pilonidal sinus of the neck following trauma due to shaving. Excision of the sinus with primary repair resulted in complete healing of the lesion with no recurrence. The possible pathogenesis of this acquired condition is also discussed.

Adult↗
PubMed1995

[Therapy of pilonidal sinus with the Limberg transposition flap].

Pilonidal sinus can not be mentioned as a minor surgery procedure because of high recurrence rate, high morbidity and long disability period. In our clinic between the years of 1988-1991, 92 pilonidal sinus cases were treated primarily with Limberg's flap technique. Only in two cases, late wound healing was detected, no other complications and no recurrences were seen. Compared with other primary treatment methods, Limberg's flap technique was observed to be much more convenient for pilonidal sinus cases.

Adult↗