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Results for “Pilonidal Sinus”

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PubMed2007

[Case studies of iatrogenic tracheal injury during intraoperative ventral positioning. Symptoms, diagnostics, and differential therapy].

Two patients 16 and 21 years old developed tracheal rupture during elective surgery following trouble-free orotracheal intubation and intraoperative ventral positioning. The injuries remained undetected in both patients for more than 12 h. Diagnostic investigation after the onset of first symptoms indicated in each a tear in the posterior tracheal wall. Early operation prevented the development of serious complications in both patients. The casuistics indicate that tracheal injuries can emerge in minor elective surgery that may be carried out on an outpatient basis, and ventral positioning for surgery may represent a risk factor for their occurrence. Clinical symptoms, diagnostic procedure, findings, and therapy are discussed.

Adolescent↗
PubMed1996

[Eruptive vellus hair cysts].

Eruptive vellus hair cysts are rare epidermal cysts with vellus hairs, which appear in children or young adults. A 21-year-old patient is reported who developed asymptomatic comedo-like papules on his face, neck and chest. Histopathologically, epidermoid cysts with a fine stratum granulosum, laminated keratinous material and numerous vellus hairs were found in the mid-dermis. Evaluation of immediate family members revealed that the patient's father was similarly affected. Eruptive vellus hair cysts and steatocystoma multiplex are clinically similar, but have distinctive histopathological features and should be regarded as distinct entities.

Adult↗
PubMedDate not supplied

Cutaneous ciliated cyst with interspersed apocrine features presenting as a pilonidal cyst in a child.

We present a case of a cutaneous ciliated cyst that presented in a 13-year-old female. The lesion was felt to be a pilonidal cyst, based on its location and clinical appearance. This case is unusual because it is the youngest reported example of this very rare lesion. In addition, the admixture of apocrine and ciliated cells is extremely unusual. The histogenesis of cutaneous ciliated cysts is considered.

Adolescent↗
PubMed2006

Cutting seton for pilonidal disease: a new approach.

I present a technique for dealing with chronic pilonidal disease that avoids use of general anesthesia, long hospital stay, complex wound care and prolonged disability that has so often been associated with more traditional surgical treatment in the past. Satisfactory resection was achieved by means of a single cutting seton (garrotte) in 8 patients, 5 males and 3 females ranging in age from 18 years to 31 years, all of whom had had prior unsuccessful incision and drainage for long-standing disease with local abscesses and suppuration. The seton was applied in an ambulatory care setting under local anesthesia. It was tied and progressively tightened over a period of two weeks. Complete excision of the diseased area was achieved and revascularization of the wounds site occurred with optimum healing by secondary intention, leaving an acceptable scar. It required minimal wound care. There were no recurrences over an average follow-up period of 22.5 months. All patients were uniformly satisfied. The encouraging preliminary results for this novel technique suggest that it is simple, safe and effective. It requires evaluation in a larger series with longer follow-up.

Catheterization↗
PubMed2006

Superiority of asymmetric modified Limberg flap for surgical treatment of pilonidal disease.

PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetric modified Limberg flap were compared with respect to complications and patient comfort in the postoperative period. METHODS: In this prospective, randomized study, 68 of 70 patients were followed for a mean of 29.22 (range, 6-44) months after wide excision plus classic Limberg flap (Group 1, n=35) and after asymmetric modified Limberg flap closure (Group 2, n=33). RESULTS: There were significantly more macerations in Group 1 (P<0.001). All macerations were detected on the lower part of the incision left on the intergluteal sulcus, and infections occurred subsequent to maceration. The infection rate was statistically higher in Group 1 than in Group 2 (P=0.028). We noted that as a result of these complications, time to suture removal (P=0.001), discharge from hospital (P=0.001), and time off from work (P=0.001) were significantly longer for Group 1 than for Group 2. There were two recurrences in the inferior part of the suture line in Group 1 and none in Group 2, which showed no statistical difference (P=0.493). CONCLUSIONS: The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.

Adolescent↗
PubMed2006

The importance of local subcutaneous fat thickness in pilonidal disease.

PURPOSE: This study was designed to investigate the local subcutaneous fat thickness in sacrococcygeal pilonidal disease. METHODS: Subcutaneous fat thickness was measured by ultrasonography in 125 patients with sacrococcygeal pilonidal disease and 125 age-matched, body mass index-matched and gender-matched controls. RESULTS: The sacrococcygeal subcutaneous fat thickness was 14.4 +/- 2.9 mm, 18.3 +/- 3.1 mm, and 22 +/- 2.2 mm, respectively, in normal, overweight, and obese patients with sacrococcygeal pilonidal disease and 9.1 +/- 3.1 mm, 11.3 +/- 2.6 mm, and 20 +/- 1.8 mm, respectively, in normal, overweight, and obese controls. Sacrococcygeal fat was significantly thicker in normal and overweight patients with pilonidal disease compared with controls with same body mass index (P< 0.01). There were no significant differences in fat thickness between obese patients and obese controls (P > 0.05). CONCLUSIONS: Sacrococcygeal fat thickness, as a local factor, is closely associated with pilonidal disease.

Adult↗
PubMedDate not supplied

Treatment of malignancy arising in pilonidal disease.

BACKGROUND: Malignant degeneration is a rare complication of pilonidal disease and is associated with a high recurrence rate and poor prognosis compared with regular nonmelanoma skin cancer. Treatment in our departments and in the international literature was evaluated. METHODS: We analyzed the data from three patients with malignant degeneration who were treated in our departments and an additional 56 patients who were found after an extensive literature search. RESULTS: A total of 47 males and 12 females, with a mean age of 52 years, were most frequently primarily treated with surgery. After a mean follow-up time of 28 months, 20% of all patients died with evidence of disease and an additional 10% died of unrelated causes. The overall recurrence rate was 39%, with a median time to recurrence of only 9 months. The local recurrence rate was lower when radiotherapy was added to surgical treatment alone (30% vs. 44%). Re-excision of local recurrence resulted in some long-term survivals. CONCLUSIONS: Early diagnosis and treatment may lead to improvement of the relative poor prognosis. Surgical treatment should be tailored according to the locoregional extent. The high recurrence rate after surgical treatment can be reduced by the addition of radiotherapy. Although repeat surgery for recurrent disease may involve extensive resection and morbidity, this may result in prolonged survival.

Adolescent↗
PubMed1978

Pilonidal cyst: an operative approach.

An operative technic is presented which has been used on fifty-four patients with pilonidal cyst. This technic has resulted in primary union and complete healing within six weeks in 89 per cent of cases. The use of an incision that crosses the vertical gluteal fold at an angle and eliminates the suture line in the gluteal fold has been beneficial in all patients on whom it was used.

Humans↗
PubMed1987

Repeat pilonidal operations.

Radical excision of pilonidal disease is unwarranted. The unhealed wound which may follow such surgery can be salvaged by the technique of cleft closure. Should repeat operation become necessary, the technique of cleft closure should be performed. It is simple, causes little disability, results in primary wound healing, and requires minimal postoperative care. The operation is directed against the cause of both pilonidal disease and the unhealed wound, which appears to be skin pulling away from bone, and not against the abscess in fat, which is a secondary effect.

Buttocks↗