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At least 811 records · Page 45Linked to original sources
PubMed1980

Aerobic and anaerobic bacteriology of pilonidal cyst abscess in children.

Aspirates of pus from pilonidal abscesses in 25 children were studied for aerobic and anaerobic bacteria. A total of 76 isolates (63 anaerobic and 13 aerobic) were recovered from the patients, accounting for 2.52 anaerobes and 0.52 aerobes per specimen. Anaerobic organisms were recovered from all the specimens, and in eight cases (32%) they were mixed with aerobic organisms. The predominant anaerobic organisms were Bacteroides sp (36 isolates, including ten B fragilis group and ten B melaninogenicus group), Gram-positive anaerobic cocci (16). Fusobacterium sp (five), and Clostridium sp (four). The predominant aerobic organisms were Escherichia coli (four) and group D streptococci, alpha-hemolytic streptococci, and Proteus sp (two of each). We believe this study is the first to demonstrate the mixed anaerobic and aerobic bacteriology of pilonidal cyst abscesses in children.

Abscess↗
PubMed2002

Failed pilonidal surgery: new paradigm and new operation leading to cures.

HYPOTHESIS: Refractory pilonidal disease is due to damage of the epidermis in the deep gluteal cleft by moisture and bacteria, rather than to damage in deep tissues. A new paradigm suggests that a procedure to change the shape of the gluteal cleft will improve results. DESIGN: Before-and-after trial. SETTING: Community private practice with extensive experience in pilonidal disease, providing ambulatory and hospital care. PATIENTS: Thirty-one patients with severe refractory pilonidal disease, with a median follow-up of 20 months in 27 patients (87%). Patients had undergone a total of 141 operations with wounds still open for a combined total of 252 years. INTERVENTION: The deep gluteal cleft was reshaped with a skin flap. Deep tissue was left essentially intact. MAIN OUTCOME MEASURES: Number healed, time to healing, number of operations required. RESULTS: Wounds in all 31 patients healed, 28 after a single procedure. The time to healing was rapid, within 1 week in 22 patients. There were no recurrences. CONCLUSIONS: For refractory pilonidal disease, the cleft lift procedure produced rapid results by drawing intact skin over the cleft and bringing the suture line out to open air. The failures of old methods and success of this new one suggest a need for a paradigm shift in our understanding of pilonidal disease. The source of disease is not the deep tissue but rather the epidermis in the moist, hypoxic, and bacteria-laden gluteal cleft. This also has implications for initial treatment of pilonidal disease, where simple, nonoperative treatments are often effective.

Follow-Up Studies↗
PubMed2000

Nd:YAG laser surgery for the excision of pilonidal cysts: a comparison with traditional techniques.

BACKGROUND AND OBJECTIVE: Nd:YAG laser photothermal ablation has been accepted as a treatment modality for hemorrhoidal disease. There is little reported on its use in treating pilonidal disease. We hypothesized that laser would be an excellent tool for pilonidal cystectomy, facilitating improved outcome and patient satisfaction. STUDY DESIGN/MATERIALS AND METHODS: A 5-year retrospective study was performed comparing Nd:YAG laser to the standard surgical technique. A telephone questionnaire addressing the length of time the cyst was debilitating both preoperatively and postoperatively as well as length of convalescent time before return to work was administered. Pain was assessed by using an analog pain scale. RESULTS: Operative time for the traditional pilonidal cystectomy was 20 minutes longer than Nd:YAG laser cystectomy. Postoperative hospital stay was similar. Laser patients returned to work an average of 2.4 days earlier, and their postoperative pain was less than those treated traditionally. CONCLUSION: In an era when the medical consumer makes decisions based on the efficacy of treatment by using criteria such as pain, length of hospitalization, and speed of return to work, Nd:YAG lasers have emerged as a surgical tool that can fulfill these criteria for certain procedures. Patient postoperative satisfaction after laser excision was greater when compared with those who had traditional excisions. Postoperative pain was less, as was the pain experienced during the first week of recovery. Cost for both was comparable.

Absenteeism↗
PubMed1988

Prognosis after simple incision and drainage for a first-episode acute pilonidal abscess.

During a 3-year period 73 patients were treated consecutively for a first-episode acute pilonidal abscess with simple incision and drainage under local anaesthesia. In all cases the treatment relieved symptoms and all patients returned to work immediately after treatment. Healing per primam occurred in 42 patients (58 per cent; 95 per cent confidence limits: 45-69) within 10 weeks after treatment. These patients had significantly fewer pits and lateral tracts compared with patients who developed excessive granulation tissue after incision and who required definitive surgical treatment later. Nine patients (21 per cent; 95 per cent confidence limits: 10-37) with healing per primam developed recurrence of their pilonidal disease during the prospective follow-up period (median follow-up period was 60 months, range 36-84 months). Actuarial analysis of the data revealed a constant cure rate of 76 per cent (95 per cent confidence limits: 57-95) after 18 months.

Acute Disease↗
PubMed2005

Randomized clinical trial comparing primary closure with the Limberg flap in the treatment of primary sacrococcygeal pilonidal disease.

BACKGROUND: The purpose of the study was to compare the outcome of excision and primary closure with that of rhomboid excision and the Limberg flap procedure in patients with primary sacrococcygeal pilonidal disease (SPD). METHODS: Two hundred consecutive patients with SPD were randomly allocated to undergo either excision and primary closure (group 1, n = 100) or rhomboid excision and the Limberg flap procedure (group 2, n = 100). Duration of operation, postoperative pain, time to first mobilization, length of hospital stay, postoperative complications, time to resumption of work, recurrence and time to recurrence were recorded for all patients. RESULTS: : Duration of operation was longer in group 2 than in group 1 (P = 0.001). However, postoperative pain was less (P < 0.001), mobilization earlier (P < 0.001), duration of hospital stay shorter (P < 0.001), time to resumption of work shorter (P < 0.001) and postoperative complications fewer (P < 0.001) in group 2. During a median follow-up of 28 months, no recurrence was detected in patients in group 2 versus 11 patients in group 1 (P = 0.001). CONCLUSION: Because of its low complication rate and acceptable long-term results, rhomboid excision and the Limberg flap procedure is preferable to simple excision and primary closure in the treatment of SPD.

Adolescent↗
PubMed1984

Laser surgery for soft tissue purulent diseases.

The original techniques of soft-tissue purulent lesion treatment by means of a continuous-wave CO2 laser are elaborated. The following laser treatment advantages--minimal tissue damage, prophylaxis of local dissemination of infection, haemostatic and sterilizing effects--have been proved experimentally. Laser utilization in clinical trial (360 cases) made it possible to obtain significantly improved outcomes and marked shortening of treatment.

Abscess↗
PubMed1987

The use of the carbon dioxide laser permits primary closure of contaminated and purulent lesions and wounds.

Excision of contaminated and purulent wounds with the carbon dioxide laser makes it safe to close the wounds primarily when certain steps are observed during the operation. The contaminated surface is sterilized with the defocused beam. The surgeons' and assistants' hands should not touch the contaminated areas, and both should wear two pairs of rubber gloves to protect against accidental contamination. All infected tissue is excised completely, and the wound cleansed by copious irrigation and the defocused laser. The wound may then be safely closed by simple sutures, skin graft, or by the rotation of a vascularized musculocutaneous flap. A series of cases are presented in order to illustrate these points.

Abscess↗
PubMed1987

Hair-containing lesions within the anal canal.

Hair-containing lesions located in the anal canal are an exceedingly rare clinical entity of which only five cases have been reported previously. We add five more cases, including two with a bundle of hairs rooted inside the anal canal and stemming out through a mucosal opening.

Adult↗
PubMed1991

Toxic shock syndrome after pilonidal cystectomy. Report of a case.

Toxic shock syndrome is an uncommon disease associated with staphylococcal infections. Although most frequently reported in menstruating women and associated with tampon use, toxic shock syndrome has been described following many types of surgical procedures. In this report we describe a case of toxic shock syndrome occurring in a previously healthy young man after elective surgery for a pilonidal cyst.

Adult↗