Pilonidal Sinus And Its Treatment
Pilonidal sinus disease is mainly the cavity or abscess tissue with hair. It most often settles on the coccyx. There are two theories of development.
Plonidal sinus and hair treatment
Pilonidal sinus disease is mainly the cavity or abscess tissue with hair. It most often settles on the coccyx.
There are two theories of development.
1. Congenital theory: In this theory, it is assumed that while in the womb (fetus), subcutaneous tissues develop as a dermal cyst residue due to incomplete joining of the midline
2. Acquired theory: It is assumed that the free hair enters the skin by being stuck in the skin, infection under the skin, the development of abscesses and the opening of the abscess to the pilonidal sinus. Today, acquired theory is more widely accepted.
Risk factors:
The body is hairy and the amount of hair loss
Narrow and deep hips
Skin remains moist and masere
Crack or scar texture in the region
Sitting for a long time
Poor hygiene is the most important risk factor.
The most common finding is that there is one or more small holes (sinus mouth) on the coccyx 3-5 cm above the anus.
Complaints:
Unless infected, there may be no complaints other than pink discharge from the holes.
Infection and abscesses may develop within the underlying sinus. In this case, sudden onset of red, hot, delicate swelling occurs and continuous throbbing style pain occurs. After this period, the swelling may spontaneously discharge with a malodorous yellow discharge or may be evacuated by local surgical intervention. If permanent intervention is not performed after the abscess has been evacuated, abscess attacks may recur.
TREATMENT:
There is no need for additional treatment, except for recommendations, in a small, uncomplicated disease that has no symptoms, no complaints, no abscess attacks.
If an abscess occurs
The abscess is drained. After evacuation, the disease recurs 30-50%. In order to reduce the risk of recurrence, crystalline phenol may be applied together with the discharge process. However, it is not always a preferred procedure since it may increase the risk of abscess formation in the abscess tissue.
Crystalline phenol treatment, known as non-surgical method, or surgical methods should be applied in chronic pilonidal disease causing leaks.
Application of Crystallized Phenol: In this method, after the anesthesia is anesthetized with local anesthesia, the hairs and epithelial tissue are cleaned by entering the sinus mouth with a thin instrument without any additional incision. Crystalline phenol is then introduced into the sinus to accelerate healing. Since this method is applied with local anesthesia and no additional incision is made, it affects the daily life of the patient very little. The chance of success is 80-90%, the risk of recurrence is 5% and it is close to surgical treatment.
Surgical Methods
Cystotomy: The sinus ceiling is opened, the inside is cleaned and cureted and allowed to heal. Healing takes 4-6 weeks and the risk of recurrence is 5-19%.
Bascom Surgery: Similar to cystotomy. Not only the incision is made from the side of the cyst.
Complete removal of the pilonidal sinus: After removal:
Spontaneous healing can be expected by leaving the wound open. The risk of relapse is moderately low (1-6%) but recovery is long-lasting.
The wound can be closed directly. The recovery is partially rapid but the risk of recurrence is high (16-22%).
Flap methods (Karydakis, Limberg, Dufourmental flap, Z plasty): Various flap methods can be used at the wound site that cannot be mutually sutured without direct tension. The risk of recurrence is lower. In most cases the incision will be larger and the scar is larger.
The most annoying point after pilonidal disease treatment is the risk of recurrence. To reduce the risk of recurrence
The coccyx (at least 3-4 cm radius of the sinus) should be removed from the hair
Shower daily (cotton and hairs removed)
Treatment method is surgical application
Scar tissue should not be in the midline
The wound should heal without being infected
Tissue should be closed without tension during surgery
There should be no dead spaces in the middle line.
43AXX
Afrin Original Spray, 0.5 Ounce
