Quality of life of pediatric patients operated for pilonidal sinus disease

Esposito, Ciro; Lepore, Benedetta; Cerulo, Mariapina; Borgogni, Rachele; Conte, Fulvia Del; Coppola, Vincenzo; Mento, Claudia Di; Carulli, Roberto; Cardone, Roberto; Cortese, Giuseppe; Esposito, Giulia; Escolino, Maria

doi:10.1007/s00431-022-04678-3

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…For children and adolescent patients, in the critical period of personality development, the mind is more fragile, the mood swings are relatively large, and they are more susceptible to the impact of the disease 133 . Minimally invasive treatment involves a shorter hospital stay and less postoperative scarring, and thus can rapidly resolve the negative impact of the disease on young patients’ quality of life 17 , 134 . Hence, EPSiT, VAAPS, and Gips trephination can be used as the preferred minimally invasive technique 135 .…”

Section: Discussionmentioning

confidence: 99%

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

Zhang

Wang

2023

International Journal of Surgery

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Background: A pilonidal sinus (PS) is an acquired disease resulting from recurrent infections and chronic inflammation. A PS involving the sacrococcyx is referred to as a sacrococcygeal PS (SPS). An SPS is a rare chronic infectious disease for which surgery is a good choice. The incidence of SPS has gradually increased worldwide in recent years. However, surgeons have not reached a consensus on the preferred surgical approach for SPS. The authors performed a systematic review and meta-analysis to analyze differences in the efficacy of different surgical approaches for the treatment of SPS. Methods: A systematic search was conducted in the PubMed database covering the period from 1 January 2003, to 28 February 2023. The primary outcome parameters were recurrence and infection. Finally, statistical analysis (meta-analysis) was carried out using RevMan 5.4.1 software. In addition, we systematically reviewed the latest progress in the surgical treatment of SPS over the past 20 years, especially as reported in the past 3 years. Results: Twenty-seven articles, 54 studies, and 3612 participants were included in this meta-analysis. The recurrence rate following the midline closure (MC) technique was much higher than that of other techniques. Among the techniques analyzed, the differences between MC and Limberg flap (LF), and between MC and marsupialization were statistically significant [P=0.0002, risk ratio (RR)=6.15, 95% CI 2.40, 15.80; P=0.01, RR=12.70, 95% CI 1.70, 95.06]. The recurrence rate of open healing was higher than that of the Karydakis flap (KF) technique, and the difference was statistically significant (P=0.02, RR=6.04, 95% CI 1.37, 26.55). Most of the results comparing MC with other techniques suggested that the former had a higher infection rate, and the difference between MC and LF was statistically significant (P=0.0005, RR=4.14, 95% CI 1.86, 9.23). Comparison between KF and LF, modified LF and KF showed that the differences were not statistically significant in terms of recurrence and infection (P≥0.05). Conclusions: There are various surgical treatment options for SPS, including incision and drainage, excision of diseased tissue with primary closure and secondary healing, and minimally invasive surgery. It is still not possible to determine which surgical technique should be considered the gold standard for treatment, as even the results of different researchers using the same operation method are conflicting. But what is certain is that the midline closure technique has a much higher incidence of postoperative recurrence and infection than other techniques. Therefore, the anorectal surgeon should formulate the most suitable individualized plan for the patient based on a comprehensive evaluation of the patient’s wishes, appearance of the SPS, and the professional ability of the surgeon.

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Section: Discussionmentioning

confidence: 99%

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

Zhang

Wang

2023

International Journal of Surgery

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“…Thirteen of 38 patients who received phenol were included in the prolonged wound care group, and 10 of these patients had been administered phenol at least once in the outpatient setting. Undoubtedly, the application of crystalline phenol is becoming increasingly common as a treatment option that has very low morbidity compared with surgical methods, is simple to apply, inexpensive, reproducible, has no complications and allows rapid return to normal activities 16–18 . Phenol is a caustic, antiseptic, germicidal and weak sclerosing agent and has a local anaesthetic effect 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Undoubtedly, the application of crystalline phenol is becoming increasingly common as a treatment option that has very low morbidity compared with surgical methods, is simple to apply, inexpensive, reproducible, has no complications and allows rapid return to normal activities. 16 , 17 , 18 Phenol is a caustic, antiseptic, germicidal and weak sclerosing agent and has a local anaesthetic effect. 19 Crystalline phenol melts at body temperature and shows its effect in liquid form.…”

Section: Discussionmentioning

confidence: 99%

New factors affecting wound healing and recurrence after pilonidal sinus surgery in adolescents; seborrheic dermatitis and psychiatric co‐occurring conditions

Kaba

2023

International Wound Journal

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Postoperative wound healing problems and recurrence remain common for pilonidal sinus disease (PSD). Our study aimed to examine the effect of comorbidities in addition to the classic known factors that may affect wound complications and recurrence after PSD surgery. We retrospectively analysed 282 adolescent patients operated on in our clinic between 2014 and 2021. We gathered the postoperative wound healing patterns of the patients under four groups. With a mean age of 15.49 ± 1.45, 59.9% (n = 169) were male, 40.1% (n = 113) were female and 23.8% (n = 67) had recurrence. When examined according to the wound healing groups, 53.5% (n = 151) had an uneventful wound, 22.6% (n = 64) had prolonged wound care, 17.7% (n = 50) of the postoperative wounds did not close and had a recurrence and 6% (n = 17) had recurrence after the wound was healed. The number of sinuses, abscess presentation and the incidence of comorbid disease in group 1 were found to be statistically significantly lower than all other groups. Seborrheic dermatitis, obesity and psychiatric diagnoses showed high statistical association with group 3 and acne with group 4. In patients with seborrheic dermatitis or psychiatric diagnosis, a significant correlation was found between wound healing according to the type of surgery (p < 0.05). The wound healing patterns of these patients after total excision and primary closure surgeries were included in Group 3 with a statistically significant high rate. As two new factors, the significance of the presence of seborrheic dermatitis and psychiatric comorbidities should be evaluated in these patients whose wounds remain open postoperatively and do not respond to primary wound care and eventually relapse. Further histologic and pathologic investigations are needed for seborrheic dermatitis and PSD relation. Awareness of these diseases may change the decision of the type of surgery, and their treatment within the same time may support wound healing and ultimately reduce recurrence.

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