UNROOFING AND CURRETAGE IS AN EFFECTIVE TREATMENT METHOD IN PATIENTS WITH PILONIDAL SINUS DISEASE
Purpose:Pilonidal sinus is a chronic disease with important morbidity.There is no gold standart treatment up to date.The aim of this study is to report results of unroofing and curettage technique in pilonidal sinus surgery.
Material and Methods:The data of patients who were operated with unroofing and curettage technique were collected retrospectively. Patients' age, gender, body mass index (BMI), duration of symptoms, presence of abscess in preoperative period, antibiotic usage and drainage, operation findings, postoperative complications, wound healing time, recurrences were recorded. NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used for statistical analysis.
Results: A total of 172 patients who underwent unroofing and curretage during 3 years period were studied retrospectively. There were 146 (84.9%) male and 26 (15.1%) female patients. The mean operation time was 18.52 ± 12.49 minutes (5-90 min). Postoperative infection rate was 2.9% (n = 5) and bleeding rate was 1.7% (n = 3). Recurrence was found in 13 of the patients (7.6% ). Return to work was ranged from 0 to 90 days with an average of 14.41 ± 13.10 days.
Conclusion: Unroofing and curettage technique can be used under local anesthesia with outpatient basis. It can be prefered as a first line treatment modality in pilonidal sinus surgery.
- Duman K, Gırgın M, Harlak A. Prevalence of sacrococcygeal pilonidal disease in Turkey. Asian J Surg. 2017 ;40:434-437.
- Hodges RM. Pilonidal sinus. Boston Med Surg J. 1880; 103: 485-486.
-McCallum IJD, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008;336: 868–871.
-Søndenaa K, Anderson E, Soreide JA. Morbidity and shortterm results in a randomised controlled trial of open compared to closed treatment of chronic pilonidal sinus. Eur J Surg 1992;158:351–355.
-Doll D, Matevossian E, Wietelmann K, Evers T, Kriner M, Petersen S. Family history of pilonidal sinus redisposes to earlier onset of disease and a 50% long-term recurrence rate. Dis Colon Rectum 2009;52:1610–1615.
Mayo O. Observations on injuries and diseases of the rectum. London: Burgess and Hill, 1833
Franckowiak JJ, Jackman RJ. The etiology of pilonidal sinus. Dis Colon Rectum.1962; 5:28–36.
Allen-Mersh TG. Pilonidal sinus: finding the right track for treatment. Br J Surg. 1990;77:123-132.
Karydakis GE. New approach to the problem of pilonidal sinus. Lancet. 1973;22:1414-5.
Søndenaa K, Pollard ML. Histology of chronic pilonidal sinus. APMIS 1995;103:267–272.
Lorant T, Ribbe I, Mahteme H, Gustafsson UM, Graf W. Sinus excision and primary closure versus laying open in pilonidal disease: a prospective randomized trial. Dis Colon Rectum 2011; 54:300–305.
Gencosmanoglu R, Inceoglu R. Modified lay-open (incision, curettage, partial lateral wall excision and marsupialization) versus total excision with primary closure in the treatment of chronic sacrococcygeal pilonidal sinus: a prospective, randomized clinical trial with a complete two-year follow-up. Int J Colorectal Dis 005;20:415–422.
Perruchoud C, Vuilleumier H, Givel JC. Pilonidal sinus: how to choose between excision and open granulation versus excision and primary closure? Study of a series of 141 patients operated on from 1991 to 1995. Swiss Surg 2002; 8: 255-258.
Chiedozi LC, Al-Rayyes FA, Salem MM, Al-Haddi FH, Al-Bidewi AA.Management of pilonidal sinus. Saudi Med J 2002; 23: 786-788.
Aydede H, Erhan Y, Sakarya A, Kumkumoglu. Comparison of three methods in surgical treatment of pilonidal disease. Aust N Z J Surg 2001; 71: 362-364.
Miocinovic M, Horzic M, Bunoza D. The treatment of pilonidal disease of the sacrococcygeal region by the method of limited excision and open wound healing. Acta Med Croatica 2000;54: 27-31.
Zieger K. Complications after surgery for pilonidal cyst. An introduction to a new debate on a "costly" disease. Ugeskr Laeger 1999; 161: 6056-6058.
Lee HC, Ho YH, Seow CF, Eu KW, Nyam D. Pilonidal disease in Singapore:clinical features and management. Aust N Z J Surg 2000; 70: 196-198.
Destito C, Romagnoli A, Pucello D, Mercuri M, Marin AW. Pilonidal sinus: long term results of excision and closure technic. Review of the literature. G Chir 1997; 18: 441-446.
-Lorant T, Ribbe I, Mahteme H, Gustafsson UM, Graf W. Sinus excision and primary closure versus laying open in pilonidal disease: a prospective randomized trial. Dis Colon Rectum. 2011;54:300–305.
- Kepenekci I, Demirkan A, Celasin H, Gecim IE. Unroofing and curettage for the treatment of acute and chronic pilonidal disease. World J Surg. 2010;34:153–157.
-Garg P, Garg M, Gupta V, Mehta SK, Lakhtaria P. Laying open (deroofing) and curettage under local anesthesia for pilonidal disease: An outpatient procedure. World J Gastrointest Surg. 2015.27;7:214-8.
Copyright (c) 2019 IJRDO - Journal of Health Sciences and Nursing (ISSN: 2456-298X)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Author(s) and co-author(s) jointly and severally represent and warrant that the Article is original with the author(s) and does not infringe any copyright or violate any other right of any third parties, and that the Article has not been published elsewhere. Author(s) agree to the terms that the IJRDO Journal will have the full right to remove the published article on any misconduct found in the published article.