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Colorectal Disease : the Official... Apr 2024Research in pilonidal disease faces several challenges, one of which is consistent and useful disease classification. The International Pilonidal Society (IPS) proposed...
AIM
Research in pilonidal disease faces several challenges, one of which is consistent and useful disease classification. The International Pilonidal Society (IPS) proposed a four-part classification in 2017. The aim of this work was to assess the validity and reliability of this tool using data from the PITSTOP cohort study.
METHOD
Face validity was assessed by mapping the items/domains in the IPS tool against tools identified through a systematic review. Key concepts were defined as those appearing in more than two-thirds of published tools. Concurrent and predictive validity were assessed by comparing key patient-reported outcome measures between groups at baseline and at clinic visit. The outcomes of interest were health utility, Cardiff Wound Impact Questionnaire (CWIQ) and pain score between groups. Significance was set at p = 0.05 a priori. Interrater reliability was assessed using images captured during the PITSTOP cohort. Ninety images were assessed by six raters (two experts, two general surgeons and two trainees), and classified into IPS type. Interrater reliability was assessed using the unweighted kappa and unweighted Gwet's AC1 statistics.
RESULTS
For face validity items represented in the IPS were common to other classification systems. Concurrent and predictive validity assessment showed differences in health utility and pain between groups at baseline, and for some treatment groups at follow-up. Assessors agreed the same classification in 38% of participants [chance-corrected kappa 0.52 (95% CI 0.42-0.61), Gwet's AC1 0.63 (95% CI 0.56-0.69)].
CONCLUSION
The IPS classification demonstrates key aspects of reliability and validity that would support its implementation.
PubMed: 38644667
DOI: 10.1111/codi.16989 -
Dermatology (Basel, Switzerland) Apr 2024Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, characterized by painful and recurrent lesions in apocrine gland-bearing skin areas. It is a...
INTRODUCTION
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, characterized by painful and recurrent lesions in apocrine gland-bearing skin areas. It is a heterogeneous disease, which makes assessment and data collection difficult. Questionnaires with detailed items, such as the Belgian European Registry for Hidradenitis Suppurativa (ERHS-Be), are useful to study HS and its associated comorbidities. The aim of this registry was to uncover new factors associated with HS and understand HS patients' clinical profiles and efficacy of treatments.
MATERIAL AND METHODS
The ERHS-Be registry is based on questionnaires, with sections for sociodemographic data, medical and HS history, clinical examination, and treatment plan. It allows identification of different clinical phenotypes and automatic calculation of severity scores.
RESULTS
At present, 606 patients are included in the ERHS-Be (67% women, 33% men). The mean age at the first visit is 38.5 years. Tobacco use is present in 72.6% of patients. A family history of HS is noted in 42% of patients. Comorbidities are documented in this cohort: depression is present in 43.8% of patients, arthritis in 27.8%, obesity in 31.5%, hypertension in 10.6%, diabetes mellitus in 6.4%, and dyslipidemia in 12.4%. Moreover, 7.7% of patients suffer from IBD and 27.4% have a pilonidal sinus. History of severe acne is found in 32.1% of patients and psoriasis in 9.3%. Thirteen percent of women in our cohort suffer from polycystic ovarian syndrome. Severity of disease is quantified in 533 patients: for instance, Hurley I, II, and III scores proportions are, respectively, 32.3%, 52.7%, and 15%, while the mean IHS4 score is 5.2. This registry also enables determination of relative phenotype proportions in our cohort, according to different classifications.
CONCLUSION
The ERHS-Be questionnaires allow systematic and larger data collection, including detailed comorbidities, phenotypes, and severity of disease. Analysis of this large database will contribute to a better understanding and management of HS, at a time where new therapeutic options are becoming available.
PubMed: 38621365
DOI: 10.1159/000538804 -
JAMA Surgery Jun 2024
Topics: Humans; Pilonidal Sinus; Laser Therapy; Hair Removal; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38568687
DOI: 10.1001/jamasurg.2024.0495 -
JAMA Surgery Jun 2024
Topics: Humans; Pilonidal Sinus; Laser Therapy; Hair Removal
PubMed: 38568604
DOI: 10.1001/jamasurg.2024.0498 -
ANZ Journal of Surgery Jun 2024
Topics: Humans; Pilonidal Sinus; Male; Carcinoma, Verrucous; Skin Neoplasms; Chronic Disease; Carcinoma, Squamous Cell; Neoplasm Recurrence, Local
PubMed: 38563251
DOI: 10.1111/ans.19002 -
World Journal of Surgery May 2024Pilonidal sinus disease (PSD) is a common surgical disease. Multiple surgical methods exist in the literature, without clear consensus regarding which should be the... (Observational Study)
Observational Study
BACKGROUND
Pilonidal sinus disease (PSD) is a common surgical disease. Multiple surgical methods exist in the literature, without clear consensus regarding which should be the first-line treatment. Minimally invasive methods such as the Gips procedure are gaining popularity in recent years. The aim of our study was to assess recurrence rates following the Gips procedure and to determine whether using the same surgical approach during re-operation is efficient and successful.
METHODS
This is a single-center retrospective observational study of pediatric patients that underwent Gips procedure due to PSD between the years 2012-2022.
RESULTS
565 pediatric patients underwent an elective surgery for PSD in the study period. Recurrence rate was 8.1% (n = 46). In all the patients with recurrence, re-operation took place on average 9 months following the first surgery and using the same surgical method. Following the second surgery, only 8 patients (1%) had multiple recurrences.
CONCLUSIONS
We found a relatively low recurrence rate in the pediatric population using the Gips method, and nearly 100% success rate following the second operation. Our findings set a new benchmark for pediatric recurrence following PSD operation, with clear recommendation to use the same method of surgery upon further recurrences as well.
Topics: Humans; Pilonidal Sinus; Retrospective Studies; Female; Male; Recurrence; Child; Adolescent; Reoperation; Trephining; Treatment Outcome
PubMed: 38554245
DOI: 10.1002/wjs.12167 -
The Journal of International Medical... Mar 2024This study was performed to compare the effectiveness of laser obliteration with limited excision (LOLE) versus wide excision (WE) of the pilonidal sinus. (Observational Study)
Observational Study
OBJECTIVE
This study was performed to compare the effectiveness of laser obliteration with limited excision (LOLE) versus wide excision (WE) of the pilonidal sinus.
METHODS
A prospective, cross-sectional observational study of 152 patients with chronic pilonidal sinus disease was performed from September 2019 to September 2022. Of the 152 patients, 76 underwent LOLE and 76 underwent WE. The main evaluation criteria were complete wound healing, recurrence, and the complication rate.
RESULTS
Complete healing was achieved in 74 (97.4%) patients in the LOLE group and 76 (100%) patients in the WE group. The duration of wound healing was significantly shorter in the LOLE group than in the WE group (6.5 ± 2.4 vs. 14.5 ± 2.6 weeks, respectively). Recurrence developed in six (7.9%) patients in the LOLE group and one (1.3%) patient in the WE group, with no significant difference.
CONCLUSION
According to our study and the data available in the literature, laser surgery should be included in the guidelines for the treatment and management of pilonidal disease.
Topics: Humans; Pilonidal Sinus; Prospective Studies; Cross-Sectional Studies; Neoplasm Recurrence, Local; Lasers; Recurrence; Treatment Outcome
PubMed: 38530042
DOI: 10.1177/03000605241236057 -
Updates in Surgery Jun 2024Pilonidal disease is a common condition that commonly affects the younger adult population and is often seen in both the general practice and the hospital setting.... (Review)
Review
Pilonidal disease is a common condition that commonly affects the younger adult population and is often seen in both the general practice and the hospital setting. Multiple treatment methods have gained and lost popularity over the last several decades, but more recent intervention principles show promising results. This article details the different methods of managing acute and chronic pilonidal disease ranging from treatments in the primary care setting to those in hospital theatres, with special attention to newer modalities of minimally invasive interventions. As a chronic illness that often affects those of working age, pilonidal disease can confer significant morbidity especially, but not limited to, a substantial amount of time off work. Treatment of chronic disease in particular, has evolved from midline techniques to off-midline techniques, with more recent developments offering promising solutions to reduce acute flare ups and hasten recovery time.
Topics: Pilonidal Sinus; Humans; Chronic Disease; Minimally Invasive Surgical Procedures; Acute Disease
PubMed: 38526695
DOI: 10.1007/s13304-024-01799-2 -
The British Journal of Surgery Mar 2024
Topics: Humans; Wound Healing; Pilonidal Sinus; Recurrence
PubMed: 38518113
DOI: 10.1093/bjs/znae054