Phenolisation of the Sinus Tract in Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Prospective Cohort Study

Abstract

Phenolisation is a minimally invasive treatment option in patients with primary pilonidal disease. However, most studies focus on patients with primary pilonidal sinus disease, while data of patients with recurrent pilonidal disease are very scarce. The purpose of this study was to evaluate phenolisation of the sinus tract in patients with recurrent pilonidal sinus disease after previous surgery for SPSD. Methods This single-center prospective cohort study included 60 patients with recurrent pilonidal disease. Loss of days of normal daily activities, surgical site infection, wound epithelization, quality of life, and complaints related to pilonidal disease were postoperatively assessed. Results A total of 57 patients (95%) were treated with phenolisation and the median loss of days of normal daily activities was 5.0 (1.0-12.0) days. Fifty-one patients (89.5%) resumed normal daily activities after two weeks. Surgical site infection occurred in five patients (8.8%). Compared to preoperative scores, quality of life was significantly higher 12 weeks postoperatively (p=0.014) and pain and itch scores were lower after six and 12 weeks (p ≤ 0.005). Wounds were completely healed in 45 of 51 patients (89.8%) who were available after 12 weeks of follow-up. Conclusion Phenolisation for recurrent pilonidal disease is safe with a median complete return to daily activities within five days and complete wound healing after three months in 90%. Therefore, phenolisation should be considered as a treatment option in patients with recurrent pilonidal sinus disease.

Digital Rectal Examination: Perspectives on Current Attitudes, Enablers, and Barriers to Its Performance by Doctors-in-Training

“…First, the overall response rate was low at 27%. This is common for survey-based research involving health professionals [10][11][12]. This may result in a response bias in our study, where only individuals who felt strongly about the utility of the DRE or the level of DRE training they received would have responded to the questionnaire.…”

Randomised clinical trial to test the phenolization in sacrococcygeal pilonidal disease

“…No economic costs were incurred due to the difficulty of quantifying the cost of sick leave. However, in the bibliography, it is described that patients treated with phenolization and the median loss of days of normal daily activities was 5.0 (1.0–12.0) days and 89.5% of patients resumed normal daily activities after 2 weeks 31 …”

“…However, in the bibliography, it is described that patients treated with phenolization and the median loss of days of normal daily activities was 5.0 (1.0-12.0) days and 89.5% of patients resumed normal daily activities after 2 weeks. 31 The statistical studies developed by Calvo et al, showed that the average sick leave of patients with SPD was 50 days. The predictive factors of longer sick leave were evaluated.…”

Coccydynia

“…Infections after perineal surgeries such as pilonidal cyst excisions or surgeries for rectal prolapse may also manifest as coccygeal pain. When these procedures have occurred near the time of onset of symptoms, infection should be of high suspicion for the cause of pain, and an appropriate workup should be initiated 3,4,11,16,18,19 . When coccydynia is not associated with the hallmark coccygeal tenderness on physical examination, this may be an indication of radicular or referred pain 13 .…”