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Outpatient anorectal surgery.

Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually large hemorrhoids with generalized prolapse of mucosa and disorders involving poor-risk patients should be managed in the hospital.

Abscess↗

Comparison of three methods in surgical treatment of pilonidal disease.

BACKGROUND: The present study was designed to compare three methods that are still used for the surgical treatment of pilonidal disease: marsupialization, primary midline closure and skin flaps. METHODS: One hundred and one out of a total of 203 pilonidal disease patients underwent excision and marsupialization, while 82 patients had excision and primary closure and the remaining 20 were treated with excision and skin flaps. The minimum and maximum follow-up periods for the aforementioned surgical methods were 4 and 5 years, respectively. All patients were reviewed for in-hospital stay, return to work, wound infection and recurrence rates. Student's t-test and Fisher's exact test were used for statistical analysis. RESULTS: Average hospital stays for marsupialization, primary closure and skin flaps were 2.84 +/- 0.13, 2.62 +/- 0.12 and 5.95 +/- 0.52 days, respectively. Hospital stay for the skin flaps method was longer than that for the other two methods. The average time to return to work after marsupialization was 5.42 +/- 0.08 weeks; but the time needed to return to work after undergoing the primary closure or the skin flaps methods was much shorter: 2.15 +/- 0.05 and 2.90 +/- 0.20 weeks, respectively (P < 0.001). There was no difference in wound infection rate (P = 1.000) or recurrence rates. CONCLUSION: The fact that there were no differences in terms of wound infection or recurrence rates between the three groups, and the relatively shorter period for returning to work, emphasize the usefulness of the excision and repair techniques in the surgical treatment of pilonidal disease.

Adolescent↗

Simple wounds and simple incisions.

Wound healing without complications and with minimal scarring is facilitated in minor surgical procedures by careful attention to basic surgical principles as reviewed in this article. "Langer's lines" represent the natural creases of the skin and are helpful in locating incisions. Whenever possible, incisions should be made in the skin crease, particularly in the neck or across moving parts. Some incisions, such as those required for drainage of pilonidal or perirectal abscesses, must be carefully located with specific reference to underlying structures.

Abscess↗

[Cutaneous tumors and nodules in the neonatal period].

A review of neonatal cutaneous tumors and nodules is presented, based on a 10-year experience. Pitfalls in diagnosis are especially emphasized. A biopsy should be performed in most instances when there is a clinical doubt.

Dermoid Cyst↗