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The treatment of pilonidal disease of the sacrococcygeal region by the method of limited excision and open wound healing.

Results of the surgical treatment of the pilonidal disease of the sacrococcygeal region in correlation with anaerobic infection are analyzed. Fifty patients with the disease recurrence (group A) and fifty patients presenting for operative treatment for the first time (group B) were observed. Twenty-five patients from group B were operated on by the method of limited excision and wound healing by open granulation and the other half were operated on by the method of excision and primary suture. The material for bacteriologic examination was obtained during the operative procedure. All patients underwent control examination at twelve months after the surgery. Recurrence was found in three (6%) group A patients and two (8%) group B patients operated on by the method of excision and open wound healing. Perioperative bacteriologic analysis showed anaerobic colonization in all study patients. Among the patients operated on by the method of excision and primary suture, recurrence was recorded in six (24%) cases. Bacteriologic analysis pointed to anaerobic colonization in five, and to aerobic colonization in only one patient. The significantly lower recurrence rates recorded with the method of limited excision and wound healing open granulation, were explained by favorable conditions for healing in such a wound (reduced conditions for anaerobic infection) compared to wound healing after excision and primary suture.

Adult↗

Chondroid chordoma of the sacrococcygeal region.

This is a unique case of chondroid chordoma arising in the sacrococcygeal area of an asymptomatic man. S100 protein was detected in both chondroid and chordoid tissues; epithelial membrane antigen (EMA) and cytokeratin were present in abundant amounts in the cytoplasm of chordoma cells but not in chondroid cells. The presence of cytokeratin and EMA in chordoma implies the epithelial nature of the tumor and is extremely helpful as a differential marker for chordoma. I suggest that EMA, cytokeratin, and S100 protein should be used conjunctively to provide a resolution for difficult diagnostic problems when dealing with chordomas, especially with their variants, such as chondroid chordomas, which often cause further confusion.

Bone Neoplasms↗