Crystallized Phenol Treatment of Pilonidal Disease Improves Quality of Life

Abstract

The effects of crystallized phenol treatment of pilonidal sinus on quality of life has not been investigated before. This study aimed to compare the phenol treatment with surgical excision plus primary closure technique in terms of life quality by means of a life quality questionnaire. This is a prospective randomized clinical study. The study was conducted at Training and Teaching Hospital, Kayseri, Turkey. In total, 40 patients with pilonidal disease were randomly assigned into 2 clinically comparable groups between September 2010 and June 2011. Cristallyzed phenol application was done to 20 patients and surgical excision plus primary closure was done to 20 patients for the treatment of pilonidal disease. Data regarding demographic variables were recorded. To evaluate quality of life and patient comfort all patients asked to fill the questionnaire after complete healing occurred. There was no difference between the groups in age, sex and occupation. Two of the 20 patients in the excision and primary closure group had complication of wound dehiscience and needed prolonged wound care. There was significant differences in favor of the phenol group in all terms of life quality except for complete healing time. As a first degree treatment, phenol treatment is better than the other treatment choices of pilonidal disease in terms of time off work perioperative pain, being away from school and social life. Also phenol treatment can be done without any pretreatment laboratory examination. Further studies will be needed about cost-effectivity of phenol treatment.

Treatment of pilonidal disease by phenol application

“…It offers a good quality of life and satisfaction to patients (17,23). The rate of cosmetic problems is high with surgical methods (18).…”

“…The curettage of the sinus is often done in order to remove granulation tissue (24,31,32). Some authors use a clamp to evacuate the sinus contents, while others clean the sinus with a gauze sponge (11,17,20,22). Cleaning all the sinus content increases the effectiveness and benefits of phenol application.…”

“…2-5 gr crystalline phenol is filled into the sinus with the aid of a clamp, it quickly dissolves at body temperature, the excess phenol drains out of the sinus, and is removed carefully from the region. In some other cases, 1-4 mL of liquid phenol is injected by using a venous catheter into the sinus (14,16,17,19,21,30). Phenol impregnated into small piece of cottons can also be used (11,31).…”

“…Patients are evaluated in four different clinical forms of symptomatic disease, those with acute abscess, chronic form, fistulized form, or complex form (4,36). Pilonidal disease with acute abscess are generally considered as an exclusion criterion in studies on phenol application (14,17,31,37). Similarly, pilonidal disease with acute abscess was excluded from our study.…”

“…Phenol application, owing to its minor sclerosing effects, provides quick recovery by increasing granulation and fibrosis (9,13,15). Due to the anesthetic effect of phenol, patients experience minimal pain in the postoperative period (16,17).…”