Healing by primary versus secondary intention after surgical treatment for pilonidal sinus

McCallum, Iain; King, Peter; Bruce, Julie; Alkhamis, Ahmed

doi:10.1002/14651858.cd006213.pub2

Cited by 68 publications

(31 citation statements)

References 31 publications

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“…The factors known to increase infection rates are surgically created dead space, proximity to the anal area, and the reproduction of anaerobic bacteria in the airless environment. The high infection rate in the present study (13%) is less commonly observed in methods that leave no dead space or that create minimal dead space [19,25]. Some trials indicate that wound healing is slower in smokers and obese patients [22].…”

Section: Discussionmentioning

confidence: 44%

“…Fewer infections, recurrences, and other complications occurred and wound healing was quicker after off-midline closure than after midline closure. Recurrence rates were significantly lower (1.4%) than with midline closure (10.3%) [19].…”

Section: Discussionmentioning

confidence: 76%

“…Overall, recurrence of pilonidal sinus was more common with midline closure (11.7%) than with open healing (4.5%) which showed a 58% lower risk of recurrence at 1 year postoperatively [19]. However, wounds left open take many weeks to heal and require daily nursing care.…”

Section: Discussionmentioning

confidence: 99%

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Which surgical procedure offers the best treatment for pilonidal disease?

Saylam

Balli

Düzgün

et al. 2011

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 76%

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Which surgical procedure offers the best treatment for pilonidal disease?

Saylam

Balli

Düzgün

et al. 2011

Langenbecks Arch Surg

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“…Another patient was operated on by sinus excision and primary closure and operated on again because of a relapse of the pilonidal disease. In total, 4 patients had relapses in the excision and primary closure group compared with 1 patient in the laying open group (P ϭ .198).The scar size measured at follow-up 1 year after surgery did not differ between the sinus excision and primary closure (6.2(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)) and the laying open (5.4 (1.5-12); P ϭ .179) group.…”

mentioning

confidence: 97%

“…7,12 The importance of excising all diseased tissue and suturing away from the midline has been stressed. [15][16][17] However, all excisional procedures carry the risk of creating tissue loss and initiating chronic healing problems necessitating the need for repeated surgery and tissue transfer. One way to overcome this problem is to use less invasive procedures such as sclerosing the sinus 18 -21 or laying open.…”

mentioning

confidence: 99%

Sinus Excision and Primary Closure Versus Laying Open in Pilonidal Disease: A Prospective Randomized Trial

Lorant

Ribbe

Mahteme

et al. 2011

Diseases of the Colon &Amp; Rectum

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This prospective randomized trial shows that sinus excision and primary closure results in faster healing than laying open does, but there is no difference in healing rate after 1 year. The laying open procedure is minimally invasive with small risks for the patient, and it might therefore be considered more frequently as the first choice of treatment (www.clinicaltrials.gov. Unique identifier: NCT00997048).

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Pilonidal Disease and Hidradenitis Suppurativa

Bhama

Davis

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Pilonidal disease is an acquired chronic, infectious disease typically of the natal cleft with an unknown etiology, thought to be due to a combination of environmental and patient-specific factors.• The treatment for pilonidal disease should not result in worsening of quality of life than the disease itself. Incision and drainage for acute infections is mandatory, but further surgical treatment should be individualized. • Several operative strategies exist for the treatment of pilonidal disease; surgeons should be familiar with the various options available, though no single option has proven superior. • Wound care following pilonidal excision can have a major impact on quality of life and several nonoperative treatment strategies exist. • Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin condition that typically occurs after puberty. The primary clinical presentation is painful inflamed nodules in the apocrine gland-bearing regions that progress to abscesses, sinus tracts, and scarring. • The overall disease burden is disproportionate to the estimated prevalence, and patients with HS not seen and evaluated by dermatologists and surgeons may not get timely and appropriate treatment. • Therapy is initially medical and consists of antibiotics both orally and topically as well as immune modulators to manage the chronic inflammation. • Surgery is an important treatment for both acute abscess formation and painful scarring and deformity. Excision with primary closure and skin grafting can result in cure for patients with recalcitrant disease.

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Healing by primary versus secondary intention after surgical treatment for pilonidal sinus

Cited by 68 publications

References 31 publications

Which surgical procedure offers the best treatment for pilonidal disease?

Which surgical procedure offers the best treatment for pilonidal disease?

Sinus Excision and Primary Closure Versus Laying Open in Pilonidal Disease: A Prospective Randomized Trial

Pilonidal Disease and Hidradenitis Suppurativa

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