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Cureus Feb 2023Aim This study aimed to assess the quality and reliability of the information in YouTube videos regarding pilonidal sinus disease (PSD). Methods A total of 100...
Aim This study aimed to assess the quality and reliability of the information in YouTube videos regarding pilonidal sinus disease (PSD). Methods A total of 100 most-viewed videos on PSD were included in the analysis by two general surgeons. Video duration and content, date of upload, qualification of the video uploaders, and number of daily and total view, like, and comment counts were analyzed. We grouped the videos as those uploaded by healthcare professionals and non-professionals. The quality of the video contents was assessed with the Global Quality Scale (GQS) and the reliability of the video content with the DISCERN scoring system. Results Eighty-five (85%) videos were uploaded by professionals and 15 (15%) videos by laypersons. The average DISCERN score of the reviewed video contents was 3.18 ± 1.23, and the average GQS score was 3.39 ± 1.24. In the overall subjective evaluation, the mean DISCERN value was found as 4.01 ± 1.24 and the mean GQS value as 4.25 ± 1.25 in the useful videos. The mean DISCERN value was found as 2.32 ± 1.22 and the mean GQS value as 2.48 ± 1.25 in the misleading videos. Conclusion Our results showed that most of the YouTube videos on PSD were loaded by healthcare professionals. However, the mean quality and reliability scores were lower in videos uploaded by laypersons. Given the prevalence of PSD, physicians should be promoted for uploading accurate and professional video contents to direct patients to the right solutions for their problems.
PubMed: 36923206
DOI: 10.7759/cureus.34792 -
Cureus Feb 2023The cleft lift has been demonstrated to be one of the most successful operations for the treatment of pilonidal disease, however, there are times this procedure fails...
The cleft lift has been demonstrated to be one of the most successful operations for the treatment of pilonidal disease, however, there are times this procedure fails and further surgery is necessary. This article describes a reproducible and successful technique for the revision of a failed cleft lift. This procedure was performed on 76 consecutive patients who had previous cleft lift procedures. Failures were manifested by either a wound, sinus, abscess, dehiscence or fragile scar. The revision flattened the lower gluteal cleft with a rotation and advancement flap that placed the skin incision off-midline. Follow-up over the 10 years of this series was between six and 124 months with an average of 36 months. The revision was initially successful in 96.1% of patients; if the procedure was unsuccessful a repeat revision was subsequently curative. This procedure is proposed as an essential part of the treatment algorithm for patients with recurrent pilonidal disease after a cleft lift operation.
PubMed: 36923186
DOI: 10.7759/cureus.34511 -
POCUS Journal 2022Pilonidal sinus is a common problem encountered in proctology clinics. It has a wide spectrum of clinical picture ranging from a single asymptomatic pit to a more...
Pilonidal sinus is a common problem encountered in proctology clinics. It has a wide spectrum of clinical picture ranging from a single asymptomatic pit to a more complex disease with multiple sinuses and secondary openings. Hence, the treatment options could range from observation or simple excision to a more radical approach like flap surgeries. Ultrasonographic assessment could help in mapping the extent of the pilonidal sinus. It can also identify whether the sinus is infected or has formed an abscess. With the above-mentioned information provided by the point of care ultrasound, the surgeon can tailor the surgical approach to each individual case and improve the overall outcome. In this article, we are highlighting some examples of cases managed in our proctology unit where ultrasound was done preoperatively and guided the management.
PubMed: 36896379
DOI: 10.24908/pocus.v7i2.15543 -
Lasers in Medical Science Mar 2023The treatment of sacrococcygeal pilonidal disease (SPD) is still challenging. Although many non-surgical and surgical methods exist, no consensus has been reached on the...
The treatment of sacrococcygeal pilonidal disease (SPD) is still challenging. Although many non-surgical and surgical methods exist, no consensus has been reached on the best treatment. This study aimed to evaluate the efficacy of laser ablation using 1470-nm radial diode laser fiber in treating SPD. We retrospectively studied the data of our 48 patients who operated on this technique between March 2019 and July 2022. All patients were treated with laser ablation using 1470-nm radial diode laser fiber. The healing rate and recurrence rate, demographic and surgical data, postoperative pain, complications (wound infection, wound bleeding), the time of returning to regular work and life, and the time of wound healing were recorded. Postoperative pain was measured based on the visual analog scale (VAS) score. Postoperative follow-up was performed in the outpatient clinic every 1 week for 1 month. Among the 48 patients, 41 males and 7 females, with a mean age of 27.7 years (range 14-42), the healing rate was 100%, and the average healing time was 28.3 ± 5.5 days. Mean operative time was 15.5 ± 3.3 min. The recurrence rate was 2.1%. One patient relapsed 3 months after the operation. The patient underwent laser ablation again, and the sinus tract was closed. The median visual analog scale (VAS) score on the day of operation was 0(0,2). The median VAS score on the first, third, seventh, and fourteenth day after operation was 0(0,2), 0(0,1), 0(0,1), and 0(0,0), respectively. There was no wound infection or bleeding after the operation. The mean time to normal work/life was 7.1 ± 3.2 days. Almost all the patients felt very satisfied with the operation. Laser ablation using 1470-nm radial diode laser fiber is effective in SPD treatment. It is associated with minor wounds and mild postoperative pain. It is a simple, safe, and minimally invasive technique and its clinical application for acute and chronic SPD in the absence of abscess is promising.
Topics: Female; Male; Humans; Adolescent; Young Adult; Adult; Pilonidal Sinus; Retrospective Studies; Laser Therapy; Skin Diseases; Pain, Postoperative
PubMed: 36856904
DOI: 10.1007/s10103-023-03741-1 -
International Journal of Colorectal... Feb 2023There are only rough estimates of the worldwide incidence of pilonidal sinus carcinoma. The purpose of the study is to explore the demographic characteristics of this...
PURPOSE
There are only rough estimates of the worldwide incidence of pilonidal sinus carcinoma. The purpose of the study is to explore the demographic characteristics of this disease and to provide more precise information about its incidence.
METHODS
The study included questioning the surgeons and pathologists in Germany in addition to a literature research. The literature investigation included all published articles about pilonidal carcinoma in all languages. The questionnaire included 1050 pathologists and all 834 hospitals with a surgical division in Germany. The outcome measures included the total number of cases, the language of publication, gender, age, country of origin, interval until the diagnosis of carcinoma, and reported incidence based on local studies.
RESULTS
From 1900 to 2022, we found 140 cases of pilonidal sinus carcinoma in 103 articles. The investigation revealed two additional unpublished cases from Germany. The male-to-female ratio was 7.75:1. The countries with the most cases were the USA (35 cases, 25.0%), Spain (13 cases, 9.3%), and Turkey (11 cases, 7.6%). The average age was 54.0 ± 11.8 years and the interval between the diagnosis of the disease and the development of carcinoma was 20.1 ± 14.1 years. There was a parallel increase in reported cases of pilonidal sinus disease and pilonidal carcinoma over the last century. The reported incidence varied from 0.03% to 5.56%. The worldwide calculated incidence equaled 0.17%.
CONCLUSION
Due to underreporting and other causes, the incidence of carcinoma emerging on the background of pilonidal sinus disease is higher than reported.
Topics: Female; Male; Humans; Adult; Middle Aged; Aged; Incidence; Pilonidal Sinus; Carcinoma; Germany; Hospitals
PubMed: 36849571
DOI: 10.1007/s00384-023-04344-6 -
Annals of Medicine and Surgery (2012) Feb 2023This study aimed to investigate the coexistence of pilonidal sinus disease (PSD) and hirsutism in female patients.
UNLABELLED
This study aimed to investigate the coexistence of pilonidal sinus disease (PSD) and hirsutism in female patients.
MATERIALS AND METHODS
The demographic and clinical data of 164 female patients who underwent surgery for PSD between January 2007 and May 2014 were evaluated for this retrospective cross-sectional study. Data collected for this study were age, BMI, the modified Ferriman and Gallwey scale (mFGS) for hirsutism, main symptoms, type of surgery, early postoperative complications (wound infection, wound dehiscence), recurrence, and follow-up. The independent variables are hirsutism (mFGS scores) and BMI. Dependent variables are early postoperative complications and recurrence.
RESULTS
The median age was 20 years (95% CI for median: 19-21 years). According to the BMI, 45.7, 50.6, and 3.7% of patients were considered normal, overweight, and obese, respectively. According to the mFGS, 11, 9.8, 52.4, and 26.8% of patients were considered to have none, mild, moderate, or severe hirsutism, respectively. Fourteen (8.5%) patients had developed recurrence. Recurrence developed in six patients with primary closure, five patients with Limberg flaps, two patients with Karydakis, and one with marsupialization. There was no statistical difference between recurrent and nonrecurrent patients in terms of BMI (=0.054) and mFGS (=0.921). On the other hand, BMI was statistically significantly higher in those who developed early postoperative complications than in those who did not (<0.001).
CONCLUSION
PSD is no longer a 'men's only disease'. BMI increases the risk of early postoperative complications, but this association was not found between BMI and recurrence. Prospective multicenter studies are needed on the relationship between PSD and hirsutism.
PubMed: 36845798
DOI: 10.1097/MS9.0000000000000116 -
International Wound Journal Aug 2023Pilonidal 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...
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/m , 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.
Topics: Humans; Male; Female; Adolescent; Young Adult; Adult; Retrospective Studies; Pilonidal Sinus; Neoplasm Recurrence, Local; Surgical Flaps; Plastic Surgery Procedures; Skin Diseases; Recurrence; Treatment Outcome
PubMed: 36802113
DOI: 10.1111/iwj.14105 -
JPMA. the Journal of the Pakistan... Feb 2023Pilonidal disease occurs most commonly in those males who have to sit long hours at their work place e.g. online office workers or drivers. It is caused by piercing of...
Pilonidal disease occurs most commonly in those males who have to sit long hours at their work place e.g. online office workers or drivers. It is caused by piercing of broken hairs into the sacrococcygeal region which causes localised inflammation. Inflammation in this area due to any other foreign body is very rare. Among many treatment options for pilonidal sinus, instillation of crystalloid phenol showed promising results in terms of low recurrence rates, low post-operative complications and less healing time. Here, we present the case of a 13-year-old female student who had pilonidal sinus in sacrococcygeal region for six months and was unresponsive to multiple treatments. Later, on exploration it was revealed to contain a small foreign body of 3cm of hard straw of grass. The patient was treated with crystalloid phenol and on regular follow-up she was completely fine by the end of the third week.
Topics: Female; Male; Humans; Adolescent; Pilonidal Sinus; Skin Diseases; Crystalloid Solutions; Foreign Bodies; Inflammation; Phenol; Phenols
PubMed: 36800737
DOI: 10.47391/JPMA.4762 -
International Wound Journal Sep 2023There are controversies regarding the management of umbilical pilonidal sinuses. The current study aims to report on the efficacy of a non-operative, umbilical...
There are controversies regarding the management of umbilical pilonidal sinuses. The current study aims to report on the efficacy of a non-operative, umbilical conserving procedure in the treatment of umbilical pilonidal sinus. This is a prospective, single cohort study. The cases were managed in a single private practice center. Patients were assessed and managed throughout the previous nine years (from January 2013 to June 2022). The required information was obtained from the center's medical database. The current study included 114 patients. There were 82 (71.9%) male patients. The patients' ages varied from 14 to 56 years (mean = 23.24). The umbilicus was retracted under local anesthesia. The sinuses were cleaned with povidone-iodine. Following the drying of the cavity, the mixture was put in the umbilicus, and the area was dressed. The amount of mixture was determined by the size of the cavity. Following treatment, the patients were directly discharged home with instructions to remove all hair from the chest and abdomen and keep the dressing dry for three days. After three days, the patients were advised to use a clean cotton swab to remove the injected mixture. Recurrence was reported in 5 cases (4.4%). The current technique might be used effectively in the treatment of umbilical pilonidal sinus. It is an umbilical preserving technique with a minimal recurrence rate.
Topics: Humans; Male; Female; Cohort Studies; Umbilicus; Prospective Studies; Pilonidal Sinus; Neoplasm Recurrence, Local; Treatment Outcome; Recurrence
PubMed: 36726041
DOI: 10.1111/iwj.14111 -
International Wound Journal Aug 2023To test the efficacy and safety of phenolization in uncomplicated Sacrococcygeal pilonidal disease (SPD) the phenolization in uncomplicated SPD is feasible and secure in... (Randomized Controlled Trial)
Randomized Controlled Trial
To test the efficacy and safety of phenolization in uncomplicated Sacrococcygeal pilonidal disease (SPD) the phenolization in uncomplicated SPD is feasible and secure in selected patients in observational studies. The greatest benefits are obtained to reduce the length of sick leave (LSL) and complications. Single-center randomised controlled clinical trial. Patients were recruited at University Hospital of Tarragona Joan XXIII of Spain. Patients were randomised into two treatment groups. All patients with uncomplicated sacrococcygeal disease, localised in the midline and with only 1 fistulous orifice. The patients were randomly assigned to the phenolization group (PhG) or conventional-surgery group (CsG). Both groups were managed without admission. The main endpoint was the recurrence of sacrococcygeal disease. Secondary endpoints included time of sick leave, complications, and readmission. 124 patients were included in the study. No disease recurrence was observed in either group. Clinical follow-up was carried out with a mean of 493.8 days (SD 6.59). The LSL was shorter in the PhG (mean 19.63 days, SD 28.15) than in the CSG (43.95 days, SD 38.60). The LSL reduction was -24.31 days (P .002). The phenolization in selected SPD is a safe and feasible procedure in selected patients. This approach could become the standard of care for patients with selected Sacrococcygeal pilonidal.
Topics: Humans; Hospitalization; Pilonidal Sinus; Recurrence; Sacrococcygeal Region; Spain; Treatment Outcome; Phenols
PubMed: 36700412
DOI: 10.1111/iwj.14096