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Pilonidal Sinus

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Pediatric Surgery

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Abstract

Pilonidal sinus disease is a relatively common condition that affects hirsute adolescents and young adults. The generally accepted pathophysiology is the burrowing of hairs into the base of the gluteal cleft. This can cause acute and chronic infections. Treatment options of the chronic wound are varied including excision and closure, excision while allowing the wound to heal by secondary intention or with a vacuum-assisted closure, or a variety of flap repairs. There is however no clear consensus as to which operative treatment is the ideal.

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References

  • Afşarlar CE, Yılmaz E, Karaman A, Karaman I, Ozgüner IF, Erdoğan D, Cavuşoğlu YH, Maden HA. Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique. J Pediatr Surg. 2013;48(8):1744–9.

    Article  Google Scholar 

  • Al-Khamis A, McCallum I, King PM, Bruce J. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 2010;20(1):CD006213.

    Google Scholar 

  • Al-Khayat H, Al-Khayat H, Sadeq A, Groof A, Haider HH, Hayati H, Shamsah A, Zarka ZA, Al-Hajj H, Al-Momen A. Risk factors for wound complication in pilonidal sinus procedures. J Am Coll Surg. 2005;205(3):439–44.

    Article  Google Scholar 

  • Arda IS, Güney LH, Sevmiş S, Hiçsönmez A. High body mass index as a possible risk factor for pilonidal sinus disease in adolescents. World J Surg. 2005;29(4):469–71.

    Article  Google Scholar 

  • Arslan K, Said Kokcam S, Koksal H, Turan E, Atay A, Dogru O. Which flap method should be preferred for the treatment of pilonidal sinus? A prospective randomized study. Tech Coloproctol. 2014;18(1):29–37. EPub ahead of print.

    Google Scholar 

  • Ates M, Dirican A, Sarac M, Aslan A, Colak C. Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg. 2011;202(5):568–73.

    Article  Google Scholar 

  • Banasiewicz T, Bobkiewicz A, Borejsza-Wysocki M. Portable VAC therapy improve the results of the treatment of the pilonidal sinus – randomized prospective study. Pol Przegl Chir. 2013;85(7):371–6.

    Article  Google Scholar 

  • Bascom J, Bascom T. Failed pilonidal surgery: new paradigm and new operation leading to cures. Arch Surg. 2002;137(10):1146–50.

    Article  Google Scholar 

  • Bascom J, Bascom T. Utility of the cleft lift procedure in refractory pilonidal disease. Am J Surg. 2007;193(5):606–9.

    Article  Google Scholar 

  • Bessa SS. Comparison of short-term results between the modified Karydakis flap and the modified Limberg flap in the management of pilonidal sinus disease: a randomized controlled study. Dis Colon Rectum. 2013;56(4):491–8.

    Article  Google Scholar 

  • Can MF, Sevinc MM, Hancerliogullari O, Yilmaz M, Yagci G. Multicenter prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease. Am J Surg. 2010;200(3):318–27.

    Article  Google Scholar 

  • Cevik M, Dorterler ME, Abbasoglu L. Is conservative treatment an effective option for pilonidal sinus disease in children? Int Wound J. 2018;15(5):840–4.

    Article  Google Scholar 

  • Cubukçu A, Gönüllü NN, Paksoy M, Alponat A, Kuru M, Ozbay O. The role of obesity on the recurrence of pilonidal sinus disease in patients, who were treated by excision and Limberg flap transposition. Int J Color Dis. 2000;15(3):173–5.

    Article  Google Scholar 

  • Fike FB, Mortellaro VE, Juang D, Ostlie DJ, St Peter SD. Experience with pilonidal disease in children. J Surg Res. 2011;170(1):165–8.

    Article  Google Scholar 

  • Horwood J, Hanratty D, Chandran P, Billings P. Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trials. Color Dis. 2014;14(2):143–51.

    Article  Google Scholar 

  • Humphries AE, Duncan JE. Evaluation and management of pilonidal disease. Surg Clin North Am. 2010;90(1):113–24.

    Article  Google Scholar 

  • Iesalnieks I, Deimel S, Zülke C, Schlitt HJ. Smoking increases the risk of pre- and postoperative complications in patients with pilonidal disease. J Dtsch Dermatol Ges. 2013;11(10):1001–5.

    PubMed  Google Scholar 

  • Kallis MP, Maloney C, Lipskar AM. Management of pilonidal disease. Curr Opin Pediatr. 2018;30(3):411–6.

    Article  Google Scholar 

  • Karaca T, Yoldaş O, Bilgin BÇ, Ozer S, Yoldaş S, Karaca NG. Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus surgery. Int J Surg. 2012;10(10):601–6.

    Article  Google Scholar 

  • Karydakis GE. New approach to the problem of pilonidal sinus. Lancet. 1973;2(7843):1414–5.

    Article  CAS  Google Scholar 

  • Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992;62(5):385–9.

    Article  CAS  Google Scholar 

  • Khanna A, Rombeau JL. Pilonidal disease. Clin Colon Rectal Surg. 2011;24(1):46–53.

    Article  Google Scholar 

  • Lee SL, Tejirian T, Abbas MA. Current management of adolescent pilonidal disease. J Pediatr Surg. 2008;43(6):1124–7.

    Article  Google Scholar 

  • Limongelli P, Brusciano L, Di Stazio C, Del Genio G, Tolone S, Lucido FS, Amoroso V, D’Alessandro A, Docimo G, Docimo L. D-shape asymmetric and symmetric excision with primary closure in the treatment of sacrococcygeal pilonidal disease. Am J Surg. 2014;207(6):882–9. (Epub ahead of print).

    Google Scholar 

  • Lukish JR, Kindelan T, Marmon LM, Pennington M, Norwood C. Laser epilation is a safe and effective therapy for teenagers with pilonidal disease. J Pediatr Surg. 2009;44(1):282–5.

    Article  Google Scholar 

  • Mann CV, Springall R. ‘D’ Excision for Sacrococcygeal Pilonidal Sinus Disease. J Roy Soc Med. 2018;80(5):292–295

    Google Scholar 

  • Morden P, Drongowski RA, Geiger JD, Hirschl RB, Teitelbaum DH. Comparison of Karydakis versus midline excision for treatment of pilonidal sinus disease. Pediatr Surg Int. 2005;21(10):793–6.

    Article  Google Scholar 

  • Muzi MG, Milito G, Cadeddu F, Nigro C, Andreoli F, Amabile D, Farinon AM. Randomized comparison of Limberg flap versus modified primary closure for the treatment of pilonidal disease. Am J Surg. 2010;200(1):9–14.

    Article  Google Scholar 

  • Nordon IM, Senapati A, Cripps NP. A prospective randomized controlled trial of simple Bascom’s technique versus Bascom’s cleft closure for the treatment of chronic pilonidal disease. Am J Surg. 2009;197(2):189–92.

    Article  Google Scholar 

  • Oram Y, Kahraman F, Karincaoğlu Y, Koyuncu E. Evaluation of 60 patients with pilonidal sinus treated with laser epilation after surgery. Dermatol Surg. 2010;36(1):88–91.

    Article  Google Scholar 

  • Petersen S, Aumann G, Kramer A, Doll D, Sailer M, Hellmich G. Short-term results of Karydakis flap for pilonidal sinus disease. Tech Coloproctol. 2007;11(3):235–40.

    Article  CAS  Google Scholar 

  • Petersen S, Wietelmann K, Evers T, Hüser N, Matevossian E, Doll D. Long-term effects of postoperative razor epilation in pilonidal sinus disease. Dis Colon Rectum. 2009;52(1):131–4.

    Article  Google Scholar 

  • Pini Prato A, Mazzola C, Mattioli G, et al. Preliminary report on endoscopic pilonidal sinus treatment in children: results of a multicentric series. Pediatr Surg Int. 2018;34(6):687–92.

    Article  Google Scholar 

  • Saylam B, Balli DN, Düzgün AP, Ozer MV, Coşkun F. Which surgical procedure offers the best treatment for pilonidal disease? Langenbeck’s Arch Surg. 2011;396(5):651–8.

    Article  Google Scholar 

  • Sequeira JB, Coelho A, Marinho AS, et al. Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus disease in the pediatric population. J Pediatr Surg. 2018;53(10):2003–7.

    Article  Google Scholar 

  • Speter C, Zmora O, Nadler R. Minimal incision as a promising technique for resection of pilonidal sinus in children. J Pediatr Surg. 2017;52(9):1484–7.

    Article  Google Scholar 

  • Tocchi A, Mazzoni G, Bononi M, Fornasari V, Miccini M, Drumo A, Colace L. Outcome of chronic pilonidal disease treatment after ambulatory plain midline excision and primary suture. Am J Surg. 2008;196(1):28–33.

    Article  Google Scholar 

  • Yamout SZ, Caty MG, Lee YH, Lau ST, Escobar MA, Glick PL. Early experience with the use of rhomboid excision and Limberg flap in 16 adolescents with pilonidal disease. J Pediatr Surg. 2009;44(8):1586–90.

    Article  Google Scholar 

  • Zagory JA, Golden J, Holoyda K, et al. Excision and primary closure may be the better option in the surgical management of pilonidal disease in the pediatric population. Am Surg. 2016;82(10):964–7.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Children’s Mercy Hospital, Kansas City, MO, USA

    Jason D. Fraser & Shawn D. St. Peter

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  1. Jason D. Fraser
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  2. Shawn D. St. Peter
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Correspondence to Jason D. Fraser .

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Editors and Affiliations

  1. Our Lady’s Children's Hospital, National Children’s Research Centre, Dublin, Ireland

    Prem Puri

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Fraser, J.D., St. Peter, S.D. (2020). Pilonidal Sinus. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_110-1

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  • DOI: https://doi.org/10.1007/978-3-642-38482-0_110-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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