Microbiology of the infected recurrent sacrococcygeal pilonidal sinus

Ardelt, Michael; Dittmar, Y.; Kocijan, Roland; Rödel, Jürgen; Schulz, B.; Scheuerlein, H.; Settmacher, Utz

doi:10.1111/iwj.12274

Cited by 21 publications

(17 citation statements)

References 34 publications

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“…It is a disease that usually affects young adults. It has been suggested that hairs penetrating into the skin cause fistula formation, which starts a foreign body reaction (including partial epithelisation of the skin), ending with chronic fistula or inflammation …”

Section: Introductionmentioning

confidence: 99%

The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

Çalış

Güler

Şengül

et al. 2019

International Wound Journal

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Pilonidal sinus disease is a common disorder. We aimed to evaluate the effects of perioperative antibiotherapy on surgical site infections in pilonidal sinus patients who were treated with rhomboid excision with Limberg transposition procedure. A total of 104 patients between 18 and 40 years of age (52 males, 52 females) were included in the study. The patients were divided into two groups and evaluated because of the administration of perioperative antibiotherapy. On the 10th-day, first-month, and third-month follow ups, the status of the wound was recorded. No significant difference was found between the ages, gender distribution, and smoking. Wound dehiscence rate was higher in the non-antibiotic group on the 10th-day, first-month, and third-month follow up, whereas the rate of superficial infection was higher in the antibiotic group. None of the patients had any signs of recurrence. Antibiotic administration did not provide a significant advantage in terms of wound healing, surgical site infection, and recurrence. We think that perioperative antibiotherapy, except for patients with immunosuppression, diffuse cellulitis, or a major coexisting disease who were treated with rhomboid excision with Limberg transposition procedure, does not have any effect on healing surgical site infections and delaying early recurrence. K E Y W O R D S antibiotherapy, infection, Limberg transposition, pilonidal sinus

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Section: Introductionmentioning

confidence: 99%

The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

Çalış

Güler

Şengül

et al. 2019

International Wound Journal

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“…Thus, either preoperative bacterial colonization in chronic PSD did not cause postoperative wound complications and recurrence or the antibiotic targeting of the bacteria responsible for impaired wound healing and recurrence was insufficiently targeted. A recent study of Ardelt et al [ 25 ] was able to demonstrate a significant shift in the microbial flora in recurring PSD towards the Gram-positive range as well as a tendency towards the aerobic range. Hitherto, these bacterial changes did not alter the recurrence rate or time to recurrence in repeated disease, as 4th recurrences tend to recur not much earlier than 2nd or 1st recurrences [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

et al. 2015

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Objective: The purpose of this study was to examine the recurrence rate of wound rupture in primary pilonidal sinus disease (PSD) after median closure. Subjects and Methods: A total of 583 patients from the German military cohort were interviewed. We compared the choice of surgical therapy, wound dehiscence (if present) and long-term recurrence-free survival for patients with primary open treatment, marsupialization and primary median treatment (closed vs. secondary open, respectively). Actuarial recurrence rate was determined using the Kaplan-Meier calculation with a follow-up of up to 20 years after primary PSD surgery. Results: Patients with excision followed by primary open wound treatment showed a significantly lower 5- than 10-year recurrence rate (8.3 vs. 11.2%) compared to the patients with primary midline closure (17.4 vs. 20.5%, p = 0.03). The 20-year recurrence rate was 28% in primary open wound treatment versus 44% in primary midline closure without wound rupture. In contrast to these findings, long-term recurrence rates following secondary open wound treatment (12.2% at 5 years vs. 17.1% at 10 years) tended to be higher (although not significantly, p = 0.57) compared to primary open treatment (8.3% at 5 years vs. 11.2% at 10 years). There was no statistical difference in long-term recurrence rates between secondary open and primary midline closure (p = 0.7). Hence, despite only a short wound closure time experienced before wound rupture, the patient does not fully benefit from an open wound treatment in terms of recurrence rate. Conclusion: The postoperative pilonidal sinus wound rupture of primary midline closures did not significantly increase the 5- and 10-year long-term recurrence rates compared to uneventfully healing primary midline closures.

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“…In addition to the visualisation of the fistulas with MB usage, its antimicrobial effect is beneficial. In large abscess forming SPSD in particular, microbes are identified in approximately 80% of some cases (22) Some several publications have discussed phenol injection into the fistulas (23,24). The inflammation within the fistula system causes scarring.…”

Section: Discussionmentioning

confidence: 99%

Methylene Blue Provides an Efficient Resection for the Treatment of Pilonidal Sinus Disease

2018

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Microbiology of the infected recurrent sacrococcygeal pilonidal sinus

Cited by 21 publications

References 34 publications

The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

Methylene Blue Provides an Efficient Resection for the Treatment of Pilonidal Sinus Disease

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