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Results for “Pilonidal Sinus”

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PubMed2002

Discharging umbilicus.

OBJECTIVE: Umbilical discharge is a symptom of varied pathology. Treatment policies of this clinical problem vary among different institutions. Our experience in the management of 44 patients with umbilical discharge is presented. METHODS: This is a retrospective study of the 44 patients treated at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia over a period of 19 years from 1982 to 2001. RESULTS: With the exception of one patient, all patients were treated in the outpatient clinic. General anesthesia was not employed but instead local anesthesia was used in some cases. One patient required admission for surgical excision, diagnosed to have an ulcerating dermoid cyst. Most patients had hair tuft in the infected umbilicus (pilonidal sinus of umbilicus), 2 patients had concrete like material inside the infected umbilicus. CONCLUSION: We propose a conservative approach to treat this problem and preserve surgical excision only for selected cases.

Adult↗
PubMed1990

Incidental glomus coccygeum. When a normal structure looks like a tumor.

The glomus coccygeum is located at the tip of the coccyx; it measures several millimeters in diameter. We describe two glomera coccygea incidentally discovered in pilonidal sinus excision specimens. Review of several reports of coccygeal glomus tumors indicates that most of them probably represent normal glomera coccygea misdiagnosed as tumors. Pathologists should be aware of this normal structure.

Adult↗
PubMed1987

Staphylococcal infection of open granulating wounds.

The significance of staphylococcal infection has been studied prospectively in 250 wounds healing by open granulation. In a series of 50 axillary skin excisions, 17 became infected with Staphylococcus aureus with consequent pain and delay in healing. The infections responded well to Fucidin ointment. Nasal carriers of the organism may be especially liable to this complication. In contrast, although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied. The susceptibility of superficial wounds to the infection is ascribed to friction from dressings. Deep granulating wounds are occasionally affected similarly when the cavity has filled.

Axilla↗
PubMed1996

Early sonographic findings suggestive of the human fetal tail.

The prenatal diagnosis of a human tail was suggested in six fetuses with ultrasound findings of an echogenic protrusion in the lumbo-sacral region. All fetuses were at 14-16 weeks' gestation. The ultrasound findings disappeared in all cases at 22-23 weeks. Dermal abnormalities such as pilonidal sinus, deep dimples, and scarred tissue were found in all six newborns. It is possible that the late regression of the embryonic human tail was the cause of these dermal findings.

Animals↗
PubMed1993

[Heterologous lyophilized collagen in the secondary healing of pilonidal fistulae].

The authors evaluate heterologous lyophilized collagen efficacy and tolerability in second intention healing of pilonidal sinus fistulae. This therapeutical approach seems to be characterized by a lower relapse incidence. The use of heterologous lyophilized collagen relevantly reduces the prolonged healing time required by such method.

Adult↗
PubMedDate not supplied

[The umbilical pilonidal cyst: a case report. Comments on its etiopathogenesis and treatment].

A rare case of umbilical pilonidal sinus is reported. Epidemiology and symptoms of this disease are analyzed and possible mechanisms of formation are discussed. Clinical as well as pathological patterns observed seem to support the hypothesis of a congenital etiopathogenesis. Total omphalectomy is proposed as definitive treatment in order to avoid recurrences.

Adult↗
PubMed2001

Systematic review of antimicrobial agents used for chronic wounds.

BACKGROUND: This paper is one of a series of eight systematic reviews that aim to identify effective interventions for chronic wounds. Here, antimicrobial agents are evaluated. METHODS: Electronic databases and other relevant sources were accessed to identify published and unpublished material. Studies were eligible for inclusion if they used concurrent controls, recruited participants with chronic wounds, evaluated an intervention designed to prevent or treat chronic wounds, and incorporated an objective assessment of wound healing. All included studies were assessed against a comprehensive checklist for methodological quality. A narrative overview was conducted. RESULTS: Thirty trials were included, 25 of randomized design. Small sample size and other methodological problems meant that findings were often difficult to interpret. Results do not support the routine use of systemic antibiotics for leg ulcers or diabetic foot ulcers without acute infection, but they may be useful as an adjunct to surgery for pilonidal sinuses. Several topical preparations may be helpful, including dimethyl sulphoxide, silver sulphadiazine, benzoyl peroxide, oxyquinoline and gentamicin. CONCLUSION: Most of this research requires replication in larger, well designed studies to establish both clinical and cost effectiveness.

Administration, Topical↗
PubMed1990

Pilonidal disease of the umbilicus--a report of two cases.

Two cases of umbilical pilonidal sinus are reported herein. Both patients were young adult males aged 21 and 27 years, respectively. The predisposing factors are briefly discussed, however, the exact etiology of this disease remains unknown. Umbilectomy is the most commonly offered treatment and although it is rare, this entity probably goes undiagnosed in the majority of cases.

Adult↗
PubMed2003

Interdigitating fasciocutaneous gluteal V-Y advancement flaps for reconstruction of sacral defects.

The authors describe a modification of the classic gluteal bilateral V-Y advancement flap for sacral defect closure. After initial debridement, the V-Y design is marked on both sides of the defect. The incision is carried down to the fascia of the underlying gluteus maximus muscle. The upper and lower arms of the flaps are elevated and advanced on the gluteal muscle toward the midline, interdigitating each opposing arm. The overall result is a zigzag, broken midline suture. This procedure was carried out in 14 patients with sacral pressure sores and in 1 patient with a chronic pilonidal sinus. All flaps survived without major problems. There were no recurrences during the 6 to 16 months of follow-up. The interdigitating fasciocutaneous V-Y gluteal flap design is effective in breaking the midline vertical scar and preserving the gluteus maximus muscle.

Adolescent↗
PubMed2003

Modified Bascom's asymmetric midgluteal cleft closure technique for recurrent pilonidal disease: early experience in a military hospital.

PURPOSE: Despite the variety of surgical techniques proposed for the treatment of pilonidal disease, recurrence after its operative management remains a common occurrence. Relatively few data exist that focus on an optimal surgical approach that should be followed in cases of recurrent pilonidal disease. The aim of this study was to describe the technical details, analyze the advantages, and present the early results of a modified Bascom asymmetric midgluteal cleft closure technique applied in patients with recurrent pilonidal disease in a military hospital setting. METHODS: Among the 72 male military service patients (median age, 21; range, 18-26 years) who underwent surgery for pilonidal disease in the Military Hospital of Samos Island, Greece, there were 24 who presented with recurrent pilonidal disease eight months to four years after one to four operations each, which were performed before their enrollment in the Army (total of 43 operations). One or two midline pits were evident in 41.6 percent of the patients, whereas the rest had more complex disease. Three patients presented with acute purulent disease and required initial incision and drainage. The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat-preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin and fat tongue of tissue mobilization, and finally, complete lateralization of wound closure and flattening of midgluteal groove. RESULTS: All patients tolerated the procedure well, with minimal to moderate postoperative discomfort. Full return to military duty was possible in three weeks after surgery. There was one case of limited primary healing failure. No recurrences have developed in a short median follow-up period of ten months. CONCLUSION: The suggested modified Bascom technique is an attractive, safe, easily performed operation with minimal morbidity and can be reliably used as a second-line surgical option for recurrent pilonidal disease.

Adolescent↗
PubMed1989

Umbilical sepsis.

Pilonidal sinus of the umbilicus is rarely reported, and there are only 17 reported cases. On reviewing the records from Jordan University Hospital, 24 patients who were treated surgically for a discharging umbilical sinus were found. Three patients had known causes for their umbilical sepsis, namely stitch sinus, urachal remnant and an umbilical polyp. Of the remaining 21 patients, seven had clinical and pathological evidence of hair in their umbilicus. Most of our patients were young men who presented with discharge, soreness or pain, swelling, and cellulitis. Treatment by umbilical excision, leaving the skin defect to heal by secondary intention, proved satisfactory. The resultant scar resembles a normal umbilicus.

Adolescent↗
PubMed1983

[Surgical treatment of pilonidal disease. A new simplified technic].

A simplified technique for treatment of pilonidal sinus has been employed in 25 patients during the last 3 years. Initial results have been very encouraging as there have been no recurrences up to the present time. Mean duration of hospitalization was 3 days, patients can get out of bed after 24 hours, and work can be resumed after 2 weeks, complete healing requiring one month.

Acute Disease↗
PubMed2006

Treatment of pilonidal disease with laser epilation.

Pilonidal disease is a debilitating, chronic disease of the natal cleft. It mainly involves the sacrococcygeal region and the presentation varies from asymptomatic pits to painful draining abscesses. Treatment options vary from observation to wide excision. Unfortunately, surgical treatment often results in recurrence. The etiologic agent remains in question, as does the optimal treatment. Our objective was to assess the efficacy of laser epilation as an adjunctive therapy to surgical excision of the pilonidal sinus. Eighteen men and five women were treated with laser epilation in our office from 2001 to 2004. All patients had experienced recurrent folliculitis and had undergone some form of drainage procedure or prior excision. After surgical excision of the affected area, a Vasculite Plus laser was used for the epilation treatments. Each session involved 9 to 12 treatments and the patients underwent an average of two sessions. All 19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for further surgical procedures. During treatment, six of the men and one of the women experienced a superficial wound dehiscence. All healed with local wound care and continued laser treatments. Laser epilation is an effective adjunctive therapy for the treatment of pilonidal disease. Although not curative in and of itself, the removal of hair allows better healing and decreases the chance of recurrence by removal of a significant etiology of pilonidal disease.

Adolescent↗
PubMed1978

Outpatient excision and primary closure of pilonidal cysts and sinuses.

A procedure for outpatient excision and closure of pilonidal cysts and sinuses under local anesthesia is described. The operation is designed to reduce hospital expenses and loss of work time. It utilizes the low tissue friction properties of polypropylene sutures to effect full dead space obliteration and a home care regimen to minimize the incisional tension produced by sitting. Of thirty-two procedures performed, follow-up data were available for twenty-eight, with a mean postoperative time of twenty-four months. Full primary healing was obtained in all cases with a single early wound disruption. There have been no late recurrences.

Adult↗
PubMedDate not supplied

Microscopic pulmonary tumour embolism: an unusual presentation of thymic carcinoma.

The present report describes the first reported case of microscopic pulmonary tumour embolism (MPTE) from thymic carcinoma. The carcinoma was discovered during an autopsy in a 55-year-old man who had undergone surgery for a pilonidal sinus two weeks before presentation. Pulmonary thromboembolism was suspected. This case was unusual because MPTE has never before been associated with thymic carcinoma, MPTE was the first clinical indication of an occult malignancy, and the clinical presentation was that of sudden onset of dyspnea associated with acute cor pulmonale. The cause of death was determined to be hypoxia secondary to extrinsic compression of the right pulmonary artery and extensive tumour emboli in the small arteries, arterioles and venules of the pulmonary parenchyma. A review of the clinical presentation and diagnosis of MPTE is included.

Fatal Outcome↗
PubMed1993

[The use of a laser in the surgical treatment of an epithelial coccygeal cyst].

In acute inflammation of pilonidal sinus (PS), use of a laser scalpel permitted to reduce considerably the incidence of postoperative suppuration. Pain syndrome became less pronounced, or was absent, wound swelling disappeared at the early period. No differences in results of surgical treatment of uncomplicated PS at the stage of chronic inflammation in use of CO2-laser and conventional methods of treatment were noted. An original technique of operation for PS complicated by multiple fistulas, purulent leaks, pyodermia has been suggested. For plastic closure of a wound, the effect of laser photohydraulic preparation was used. Operated on was 31 patient, no disease recurrence was noted. Rough cicatricial deformity of the sacro-coccygeal region was absent.

Acute Disease↗
PubMed2003

[The use of drainage in the "per primam" treatment of recurrent pilonidal cysts].

Recurrent pilonidal sinus treatment is still controversial, as more and more frequently methods used determine unpleasant discomforts to the patients ("open" method) or increase recurrences rate. According to this consideration, the Authors have made a review of their cases (27 patients with recurrences), selected by standardized criteria and treated by "en bloc" excision of all pathologic tissue and following closure "per primam" of the wound, previously placing an aspirative drainage, then removed after 2 or 3 days. Ordinary use of the drainage, antibiotic prophylaxis extended to postoperative sixth or seventh day and daily careful disinfection of the wound and surrounding skin until suture removal got them excellent results.

Adolescent↗