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PubMed1990

Pediatric pilonidal disease: a method of management.

Pilonidal disease is a common problem; its many management options are testimony to the difficulty in its eradication. Its etiology is distention of midline skin orifices with ingestion of hair shafts from hirsute buttocks. Thus, the disease does not usually appear until after puberty. Nine children were treated by aspiration and incision and antibiotics, followed by curettage of the pits; they had no recurrence. Two children who had midline procedures had recurrent disease. The female-male ratio in children is 4.5:1.

Adolescent↗
PubMed2005

Glomus coccygeum: report of a case and review of the literature.

The glomus coccygeum is a vestigial structure related to the canals of Sucquet-Hoyer, an arteriovenous anastomosis surrounded by glomus cells derived from modified smooth muscle and involved in thermoregulation. It is an incidental finding in specimens from the sacral area and may represent a diagnostic challenge to the unaware observer. We present a case of a glomus coccygeum, presenting as a 1.5-mm structure adjacent to a typical pilonidal cyst excised from a 7-month-old boy, which was the subject of a second opinion consultation. The lesion showed small to medium sized clusters of predominantly epithelioid cells with moderate amounts of clear to eosinophilic cytoplasm, intercellular borders, and plump, round nuclei with fine chromatin. These cells were closely associated with small vascular channels and nerves. Immunohistochemistry revealed that the epithelioid cells expressed vimentin, muscle-specific actin, neuron-specific enolase, and S-100 protein, were weakly positive for smooth muscle actin, and negative for desmin, synaptophysin, and chromogranin. The endothelial cells of the vascular channels were antibody CD31 positive. Recognition of the histologic features of glomus coccygeum is important to avoid confusion with glomus tumor and neural or smooth muscle neoplasms in the sacral area.

Arteriovenous Anastomosis↗
PubMed1981

Treatment of granulating wounds with silastic foam dressings.

We have examined the usefulness of a Silastic foam dressing in the management of open granulating wounds in 55 outpatients. It is an acceptable and comfortable dressing, which allows earlier discharge from hospital. The method of making the dressing, and the daily care of the wound are described. Improved wound care is achieved by providing two dressings, so that when one is in place the other is being thoroughly cleaned. This technique has been shown to reduce bacterial contamination of the wounds and to improve wound healing (p less than 0.02).

Abdomen↗
PubMed2005

Recent randomised trials in colorectal disease.

Randomised trials represent the 'gold standard' for surgical research and have an important impact on clinical management. We provide an overview of the randomised trials, specifically related to the practice of colorectal surgery that were published between January and December 2003.

Colorectal Neoplasms↗
PubMed2006

Total subcutaneous fistulectomy combined with Karydakis flap for sacrococcygeal pilonidal disease with secondary perianal opening.

OBJECTIVE: Flap techniques have been performed with success in the treatment of pilonidal disease. However, some complex cases such as perianal pilonidal disease need special attention. We describe a modification of a well-known flap technique for secondary perianal pilonidal disease and its early results. PATIENTS AND METHOD: Total subcutaneous fistulotomy combined with Karydakis flap was performed on 14 patients. An elliptical incision, described by Karydakis, was made while not including the perianal opening. Both sides of the elliptical incision were deepened down to the gluteal muscle and postsacral fascia. At the level of subcutaneous tissue, attention was directed to the secondary perianal opening. A fine probe was inserted through the perianal skin pit, and the connection site between the fistula and the cyst was observed. A small circular skin incision was made around the probe and the fistula tract was totally excised using electrocautery together with the main cyst. The flap was prepared as described by Karydakis. Before suturing the flap to the other side, perianal subcutaneous tissue was sutured with a fine absorbable material, then, the flap was sutured with 4/0 polypropylene. RESULTS: One patient developed seroma. Neither early failure in wound healing nor recurrence was observed at a mean of 16.2 months (range 4-36 months) follow-up. CONCLUSION: Total subcutaneous fistulectomy plus Karydakis flap as a single-stage procedure is an effective surgical modality for sacroccocygeal pilonidal disease with secondary perianal opening.

Anal Canal↗
PubMedDate not supplied

A randomized, double-blind, placebo-controlled multicenter trial evaluating topical zinc oxide for acute open wounds following pilonidal disease excision.

The purpose of this randomized, double-blind, placebo-controlled multicenter trial was to compare topical zinc oxide with placebo mesh on secondary healing pilonidal wounds. Sixty-four (53 men) consecutive patients, aged 17-60 years, were centrally randomized to either treatment with 3% zinc oxide (n = 33) or placebo (n = 31) by concealed allocation. Patients were followed with strict recording of beneficial and harmful effects including masked assessment of time to complete wound closure. Analysis was carried out on an intention-to-treat basis. Median healing times were 54 days (interquartile range 42-71 days) for the zinc and 62 days (55-82 days) for the placebo group (p = 0.32). Topical zinc oxide increased (p < 0.001) wound fluid zinc levels to 1,540 (1,035-2,265) microM and decreased (p < 0.05) the occurrence of Staphylococcus aureus in wounds. Fewer zinc oxide (n = 3) than placebo-treated patients (n = 12) were prescribed postoperative antibiotics (p = 0.005). Serum-zinc levels increased (p < 0.001) postoperatively in both groups but did not differ significantly between the two groups on day 7. Zinc oxide was not associated with increased pain by the visual analog scale, cellular abnormalities by histopathological examination of wound biopsies, or other harmful effects. Larger clinical trials will be required to show definitive effects of topical zinc oxide on wound healing and infection.

Administration, Topical↗
PubMed1978

Abscess associated with Rothia dentocariosa.

Rothia dentocariosa, an aerobic member of the Actinomycetaceae, was isolated from a pilonidal abscess. The clinical occurrence, bacteriological characteristics, and antimicrobial sensitivity pattern are presented.

Abscess↗