Pit-picking resolves pilonidal disease in adolescents

Delshad, Hajar R.; Dawson, Michele; Melvin, Patrice; Zotto, Susan; Mooney, David P.

doi:10.1016/j.jpedsurg.2018.10.021

Cited by 30 publications

(18 citation statements)

References 14 publications

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“…Antibiotic ointment is used to cover the sutures, and daily showering is recommended. Patients have to undergo regular clinical follow-up consultations [ 58 ]. Additionally, serial postoperative laser epilation treatments are performed in hirsute patients.…”

Section: Discussionmentioning

confidence: 99%

Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children

2020

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We aimed to compare the outcome of two different operative methods to correct pilonidal sinus disease (PSD) in children, i.e., excision and open wound care (OW) versus excision and primary transverse closure (PC) of the wound. In this retrospective, observational study, we extracted data from the medical records of 56 patients who underwent surgery for PSD at our institution between 1 January 2006 and 31 December 2016. To test whether the primary variable, i.e., rate of PSD recurrence, differed between the two surgical groups, a logistic regression model was fitted. Secondary explanatory variables were total length of stay (LOS) at the hospital, complications, sex and age of patients, seniority of the surgeon in charge, and volume of excised specimen. Overall, 32 (57%) children and young adults underwent OW, while 24 (43%) patients were treated by PC. Mean age at operation was 15.5 years in either group. PSD recurred in 12 of 32 (37.5%) children in the OW group and in 3 of 24 (12.5%) children in the PC group (ratio: 0.19, 95% confidence interval [95% CI] 0.03–1.07). Thus, treatment of primary PSD by PC proved superior with respect to PSD recurrence. Moreover, our study did not bring to light any high-grade complications in the PC group, and postoperative pain was minimal. Less invasive treatment approaches for chronic PSD are typically performed in an outpatient setting and offer reduced morbidity, low rates of PSD recurrence, and shortened periods of time to return to work or social activities. More radical operations of PSD should be reserved for recurrent PSD where less invasive approaches have failed several times.

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Section: Discussionmentioning

confidence: 99%

Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children

2020

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“…The pit incisions were closed with interrupted 3-0 nylon vertical mattress sutures and the exit site wounds were left open to drain without packing. Patients were instructed to apply antibiotic ointment on the sutures twice daily, shower each morning, and soak every evening [20]. A family member or primary care provider removed sutures in 10 days.…”

Section: Methodsmentioning

confidence: 99%

Improving Resource Utilization and Outcomes Using a Minimally Invasive Pilonidal Protocol

Delshad

Henry

Mooney

2020

Journal of Pediatric Surgery

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“…Treatment Options for PD-Various treatment methods for PD have been postulated, [5][6][7] including incision and drainage, hair removal and hygiene alone, excision and primary wound closure, excision and secondary wound closure, and various flap techniques. More recently, there has been a dramatic shift to management of patients with PD in an outpatient setting.…”

Section: Commentmentioning

confidence: 99%

“…Drawbacks of operative intervention include associated morbidity; lost work and school time; and prolonged wound healing, which can take days to months. [5][6][7] For these reasons, minimally invasive surgical techniques have become popular for treating PD in adolescents, as surgery can cause less disruption of the school and examination schedule and provide an earlier return to normal activities. Gips et al 8 -who operated on 1358 adults using skin trephines to extirpate pilonidal pits and the underlying fistulous tract and hair The Gips Procedure for Pilonidal Disease: A Retrospective Review of Adolescent Patients debris-reported a low recurrence rate and good postoperative functional outcomes with this technique.…”

mentioning

confidence: 99%

The Gips Procedure for Pilonidal Disease: A Retrospective Review of Adolescent Patients

Türkyılmaz¹,

Karabulut²,

Oral³

et al. 2020

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Pit-picking resolves pilonidal disease in adolescents

Cited by 30 publications

References 14 publications

Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children

Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children

Improving Resource Utilization and Outcomes Using a Minimally Invasive Pilonidal Protocol

The Gips Procedure for Pilonidal Disease: A Retrospective Review of Adolescent Patients

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