The aetiology and treatment of pilonidal sinus. A review of 163 patients

Goodall, Peter

doi:10.1002/bjs.18004921421

Cited by 75 publications

(44 citation statements)

References 22 publications

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“…However, a clear defini tion o f what constitutes a recurrence as opposed to a post operative wound complication is often lacking [15,18]. Wound infection, previously found to be present in 44% o f our patients with recurrence [ 19], and in 27% (12/ 44) in this study, may be the promotive factor o f recurrent disease [13,14,20]. Kronborg et al [18] argue that an early recurrence is an overlooked sinus.…”

Section: Discussionmentioning

confidence: 72%

“…Recurrent sinuses have been found to be present for a shorter time than pri mary sinuses [13,16,19], This may explain the lower inci dence o f hair and lesser epithelial lining. However, in flammation and fibrosis were present to the same extent as in the primary condition [12], Our study shows that keratin plugs occur both in scar tissue (83%) and normal skin (56%) outside the scar.…”

Section: Discussionmentioning

confidence: 96%

“…It has also been argued that recur rences are caused by in-growth o f hair in wounds similar to the theory o f initial skin penetration by hair tips [11]. However, penetration o f skin is usually seen with cut hair only and tips o f loose hair points outwards [12], Early recurrence might be expected if caused by wound infection [13][14][15], Others have reported that 67-80% o f recurrences occurred during the first postoperative year [13,16,17], compared to 76% in this study, and 56% in a 118 Sandcnaa/Nesvik/Andcrscn/Pollard/ Swreide Recurrent Pilonidal Sinus Number o f patients 33 11…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Pilonidal Sinus: Etiology and Treatment

Søndenaa¹,

Nesvik²,

Andersen³

et al. 1995

Dig Surg

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A clinical and histologic study of recurrent pilonidal sinus is presented. During a 5-year period 44 patients were treated for recurrent pilonidal sinus. Of these, recurrence had occurred within 1 year in 26 patients (76%). After 26 reoperations with excision and primary suture further recurrence was seen in 23% (6/26), and in 24% (6/25) after reoperations with open treatment. The histologic findings in recurrent sinuses (18 patients) were almost identical to that of primary disease. Recurrent sinuses were situated in the scar in 80% of the cases and caudal in 50% of the cases. A known wound infection had been present in 27% of the patients. Although keratin plugs were observed in 15/18 (83%) of those with a recurrence, the importance of this finding is uncertain. We conclude that recurrent pilonidal sinuses are chronic inflammatory processes usually located at the site of the surgical wound. The cause is uncertain, although there is an indication that wound infection plays a role. Keratin plugs have also been observed in scar tissue. Surgical treatment of recurrent disease has a higher recurrence rate than after that of primary disease.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Recurrent Pilonidal Sinus: Etiology and Treatment

Søndenaa¹,

Nesvik²,

Andersen³

et al. 1995

Dig Surg

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“…Goodall (1961) reported that, of 41 patients treated in this way, 35 recurred and required further surgery within a year.…”

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confidence: 96%

The treatment of acute postanal pilonidal abscess

Millar

Lord

1967

Journal of British Surgery

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“…In these cases, surgical treatment is required. [8][9][10] The ideal approach for treating pilonidal disease should be simple, inflict minimal pain, have the best chance for cure and least local recurrence rate, avoid admission to the hospital, not require general anesthesia, require minimal wound care, pose minimal inconvenience, and require the least amount of time off work for the patient. 1,11 This study was performed to compare incision and draining (I&D) of PSA and healing by secondary intention with I&D and delayed pits excision and closure (PE/PC).…”

mentioning

confidence: 99%

Comparison of Drainage, Delayed Pits Excision, and Closure With Excision and Secondary Healing in Pilonidal Sinus Abscess Cases

Sözen

Aziret

Bali

et al. 2016

International Surgery

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A pilonidal abscess is an emergency situation which requires immediate drainage and is usually seen in young men. We aimed to compare incision and draining (I&D) of acute pilonidal abscess (PSA) and healing by secondary intention with I&D and subsequent delayed pits excision and closure (PE/PC). A total of 62 patients admitted with PSA were randomized to undergo either I&D and healing by secondary intention (group 1, n ¼ 33) or I&D and PE/PC (group 2, n ¼ 29). Demographic characteristics of the patients, abscess depth and location, duration and healing times of the symptoms, time required to return to work, and ratio of chronic pilonidal sinus (PNS) development were recorded, and the two methods were compared. No statistically significant differences were found between the groups in relation to sex, age, and preoperative findings, including discharge, infection, pain, and length and depth of abscess. There was no difference in length of hospital stay between the groups, and no statistically significant difference was found between the groups in terms of complication rate (P ¼ 0.298). A statistically significant difference (P ¼ 0.033) was, however, found between the two groups in the recurrence rate of a pilonidal abscess (9.09% in group 1 versus 3.44% in group 2). A statistically significant difference was also observed between the groups in terms of development of chronic PNS (P ¼ 0.020). According to the results of our study, I&D and PE/PC should be the primary procedure used, as opposed to skin incision, curettage, and secondary healing for the treatment of PSA.Key words: Pilonidal abscess -Drainage -Excision -Incision A pilonidal sinus (PNS) is a common condition that affects young to middle-aged adult men. The pathogenesis remains uncertain, with arguments suggesting both congenital and acquired bases for the etiology of this condition.1 PNS disease is caused by the penetration of hairs into the skin of the gluteal cleft, which, due to foreign body reaction, leads to cyst and sinus formation followed by secondary infections and abscesses. 2A pilonidal abscess is one of the most common complications associated with pilonidal disease. 3,4 Pilonidal abscesses may lead to large tissue damage and sepsis unless treated. Pilonidal sinus, which is associated with abscess exacerbations, may spread to the anal canal or perianal region. 5,6 Despite the variety of surgical techniques proposed for the treatment of PSA, the ''best method'' to use is still a matter of debate.7 Conventional treatment of a pilonidal abscess is incision and simple drainage whereby large tissue damage is prevented and the patient is relieved of pain. However, chronic PNS develops in 16% to 92.5% of patients following a simple drainage. In these cases, surgical treatment is required. [8][9][10] The ideal approach for treating pilonidal disease should be simple, inflict minimal pain, have the best chance for cure and least local recurrence rate, avoid admission to the hospital, not require general anesthesia, require minimal wound care, pose mi...

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The aetiology and treatment of pilonidal sinus. A review of 163 patients

Cited by 75 publications

References 22 publications

Recurrent Pilonidal Sinus: Etiology and Treatment

Recurrent Pilonidal Sinus: Etiology and Treatment

The treatment of acute postanal pilonidal abscess

Comparison of Drainage, Delayed Pits Excision, and Closure With Excision and Secondary Healing in Pilonidal Sinus Abscess Cases

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