Sinus pilonidalis in patients of German military hospitals: a review

Kueper, Janina; Evers, Theo; Wietelmann, Kai; Doll, Dietrich; Roffeis, Jana; Schwabe, Philipp; Märdian, Sven; Wichlas, Florian; Krapohl, Björn Dirk

doi:10.3205/iprs000061

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…Our estimated recurrence rate of 32% may seem high but is similar to many others using more extensive methods, although the reported recurrence rate after surgical treatment for pilonidal cyst varies considerably between studies [4]. Possible explanations are differences in definitions and method and length of follow as recurrences may come after many years [17,18]. We have made an effort to reach all our patients for follow-up, and all patients having symptoms suggesting recurrence were clinically assessed.…”

Section: Discussionsupporting

confidence: 70%

Minimal Excision and Primary Suture is a Cost‐Efficient Definitive Treatment for Pilonidal Disease with Low Morbidity: A Population‐Based Interventional and a Cross‐Sectional Cohort Study

et al. 2016

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BackgroundConventional treatment of pilonidal disease with wide excision is associated with high morbidity. We describe the short- and long-term results and the impact on the health care system of a simple operation performed in the office under local anaesthesia, consisting of minimal excision of pilonidal sinuses with primary suture—the modified Lord–Millar operation (mLM).MethodsAll patients operated with mLM from February 2008 till November 2012 were prospectively followed for recurrence by telephone interviews and examination of symptomatic patients till July 2015. The outcome is compared with that in all patients operated with conventional wide excision from January 2003 till February 2008. The effects on the health care system of a consistent use of mLM is analysed by comparing the management of all patients with pilonidal disease at three hospitals during 2013 and 2014.ResultsSome 129 patients underwent conventional surgical treatment, and 113 had the mLM operation. The mLM operation was more often performed under local anaesthesia, was less often admitted to hospital, had fewer post-operative health care visits (2.4 vs. 14.6, p < 0.001) and a shorter sick leave (1.0 vs. 34.7 days, p < 0.001) indicating faster wound healing. The estimated 5-year recurrence rate was similar (32 vs. 23%, p = 0.091). The cost per operated patient was lower (2231 vs. 6222 EUR, p < 0.001). The hospital consistently applying the mLM operation used less resources for pilonidal diseased patients (34,545 vs. 77,421 EUR per 100,000 inhabitants and year).ConclusionsThe mLM operation is simple, cost-efficient and has low morbidity and good long-term results.

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Section: Discussionsupporting

confidence: 70%

Minimal Excision and Primary Suture is a Cost‐Efficient Definitive Treatment for Pilonidal Disease with Low Morbidity: A Population‐Based Interventional and a Cross‐Sectional Cohort Study

et al. 2016

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“…It is also called the “Jeep cyst” because it was often found among American soldiers who used to ride jeeps during World War II. 8 , 24 Because this disease is not common among yellow people, treatment is often delayed due to misdiagnosis. 25 The author found that the ratio of men to women was 35:2.…”

Section: Discussionmentioning

confidence: 99%

The application of the Limberg flap repair technique in the surgical treatment of pilonidal sinus disease

Song

Zang

Chen

et al. 2023

International Wound Journal

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Pilonidal sinus disease (PNSD) challenged surgeons for decades. Limberg flap repair (LFR) is a common treatment for PNSD. The purpose of this study was to observe the effect and risk factors of LFR in PNSD. A retrospective study was conducted on the PNSD patients who visited two medical centers and four departments in the People's Liberation Army General Hospital and were taking LFR treatment between 2016 and 2022. The risk factors, the effect of the operation, and complications were observed. The effects of known risk factors on the surgical results were compared. There were 37 PNSD patients: male/female ratio of 35:2, average age: 25.1 ± 7.9 years. Average BMI: 25.2 ± 4.0 kg/m2, average wound healing time: 15.4 ± 3.4 days. 30 patients (81.0%) healed in stage one and 7 (16.3%) had postoperative complications. Only 1 patient (2.7%) had a recurrence while others were healed after dressing‐changing. There was no significant difference in age, BMI, preoperative debridement history, preoperative sinus classification, Wound area, Negative pressure drainage tube, prone time (<3d) and treatment effect. Squat defecate and premature defecation were associated with treatment effect, and they were independent predictors of treatment effect in the multivariate analysis. LFR has a stable therapeutic outcome. Compared with other skin flaps, the therapeutic effect of this flap is not significantly different, but the design is simple and is not affected by the known risk factors before operation. However, it is necessary to avoid the influence of two independent risk factors, squatting defecation and premature defecation, on the therapeutic effect.

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“…Surgical treatment options consist of surgical aspiration of fluctuant cystic nodules and sometimes excision of nodular lesions. Dermal fillers can be used later once inflammation resolves [14]. There have been a few case reports where laser treatment seems a promising therapeutic modality in the management of pilonidal sinus disease itself without performing any surgical interventions, especially in the initial stages of cyst formation where the treatment could be even more effective.…”

Section: Acne Conglobata (Ac)mentioning

confidence: 99%

“…A pilonidal cyst or sinus has been reported as a common suppurative condition that affects young adults in the intergluteal region through the supposed embedding of hair tracts into a damaged epithelium, which secondarily has inflammation and infection [14]. Pilonidal derives its name from Latin pilusmeaning "hair," andnidusmeaning "nest" [15].…”

Section: Pilonidal Cyst (Pc)mentioning

confidence: 99%

Deeper Seated Than Skin Deep: Report of a Rare Case of Follicular Occlusion Tetrad and a Literature Review

Ng-Wong¹,

Alexander²,

Bartl³

et al. 2023

Cureus

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Follicular occlusion tetrad (FOT) is a clinical syndrome consisting of hidradenitis suppurativa (HS), acne conglobata (AC), dissecting cellulitis of the scalp (DCS), and pilonidal cyst (PC). These entities typically occur independently, but occasionally present simultaneously comprising FOT. The four components share similar pathophysiology affecting the apocrine glands, follicular hyperkeratinization being the hallmark of each entity. Understanding shared similarities of each disease is paramount for the treatment approach as the relapsing and chronic nature of this syndrome can be burdening to patients. We present the case of a 22-year-old obese Hispanic man with a history of tobacco use who presented with worsening skin lesions. The patient developed extensive facial cystic acne 5 years before presentation, followed by left axillary hidradenitis suppurativa lesions two years before the presentation and right axillary involvement one year after. Skin manifestations then expanded to include the lower back, gluteal and perineal areas. The patient was diagnosed with FOT and despite conservative medical management, his lesions failed to improve. He ultimately underwent multiple staged excisional debridement surgeries and skin grafts. Our case underlines the presence of a syndromic association of cutaneous lesions that share a common pathogenesis and emphasizes that this entity requires a multidisciplinary approach. New biologic therapies continue to emerge and may potentially prevent the need for surgical intervention and the burden associated with it.

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Sinus pilonidalis in patients of German military hospitals: a review

Cited by 8 publications

References 39 publications

Minimal Excision and Primary Suture is a Cost‐Efficient Definitive Treatment for Pilonidal Disease with Low Morbidity: A Population‐Based Interventional and a Cross‐Sectional Cohort Study

Minimal Excision and Primary Suture is a Cost‐Efficient Definitive Treatment for Pilonidal Disease with Low Morbidity: A Population‐Based Interventional and a Cross‐Sectional Cohort Study

The application of the Limberg flap repair technique in the surgical treatment of pilonidal sinus disease

Deeper Seated Than Skin Deep: Report of a Rare Case of Follicular Occlusion Tetrad and a Literature Review

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