Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Lener, B.
Pilonidal Sinus Disease – Options for Surgical Treatment – Review
Humanmedizin; [ Diplomarbeit ] 5; 2017. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Parvizi Daryousch
- Spendel Stephan
- Altmetrics:
- Abstract:
- Background Pilonidal sinus is described as an infection of the skin affecting the sacrococcygeal region and shows a chronic, recurrent course in general. Men predominate the cases in a ratio of two to one compared to women. The overall incidence rate is reported with 26 per 100,000. The symptoms of the entity range from asymptomatic cysts to sinus evolving lesions in the midline to cases with extended manifestation affecting the surrounding area of the natal cleft. The etiology of pilonidal sinus remains under debate. Regarding the issued literature, the major part of the publishers supports the acquired theory of origin. A wide range of treatment options in PSD is in use reaching from conservative approaches to minimal invasive and simpler surgical techniques to more complex procedures and various forms of flap plastics. Purpose and measures The entity is associated with high recurrence rates, which impede the healing efforts in great measure. Due to that and based on the variety and complexity of manifestation and symptoms of the disease a definitive treatment as gold standard is still under discussion. Hence this work will give an overview of twelve established surgical treatment options, regarding the postoperative complications, the recurrence rates and the healing process. Studies of the last 15 years, surveying operative treatment in PSD, comparing two or more surgical options and publications examining patients at least 18 years old were included in the research. Conclusions Based on endemic recognitions further comprehensive studies, focusing on familial clustering of PSD, should be performed to resolve the discussion of the etiological origin of the disease. The evidence of conservative treatment options, particularly laser depilation and phenolization should be improved to broaden the range of treatment modalities. Long-term prevention measures should include increased personal hygiene, consequent hair removal if required, and the reduction of prolonged sitting intervals. Primary closure procedures perform with faster healing rates than secondary wound healing. On the contrary the second group impresses with a decreased recurrence risk. According to complications and overall healing rates similar findings were detected in both groups. Keywords pilonidal sinus, surgical treatment, etiology, risk factors, guidelines