Pilonidal disease Treatment

Pilonidal disease
Treatment
Medical Therapy
Pilonidal sinuses by phenol injection It is a therapeutic tehnnica practiced mostly in Europe. Phenol sterilize sinus tract and removes hair sequestered. Phenol injections can be combined with local excision of the sinus. Wound healing usually requires 4-8 sapatmini. The incidence is reported in 9-27% CMF, similar to that followed by simple excision and wound dressing. Due to severe inflammatory raspunsulului phenol, patients are hospitalized overnight. The next day the patient is allowed to return home with instructions to bathe daily and keep the area shaved.
Surgical therapy. Pilonidal disease is divided into three categories to determine the most effective surgical approach: acute pilonidal abscess, pilonidal disease and chronic pilonidal disease recurrence.
Pilonidal abscess It is approached through the incision, drainage and curettage of abscess cavity to remove hair and skin debris. This procedure can be performed at the reception office or urgent surgery under local anesthesia. The incision is made lateral to the midline. Median line is hard to heal wounds are interfesiere afford mechanical friction. The wound should be cleaned daily to shower and shave, to prevent hair re-wound.
3 months continuous treatment of the affected area even after complete healing of the wound. In over 905% of cases the wound is completely healed after 1 month. In 60% of patients incision and drainage without curettage in 10 sapatamini determine wound healing. Of these patients 40% will develop recurrent pilonidal sinus, which will require further treatment.
Abscess drainage is not a cure. Studies have shown that 85% of patients require further surgery. Excision pilonidal node when abcedarii reduce recurrence by 15%.
Chronic pilonidal sinus It is the term applied to patients who had an abscess drained or a pilonidal sinus. It also refers to removal associated with chronic pilonidal sinus of pus, but without an acute abscess. Pilonidal sinus surgery for chronic uncomplicated include excision with primary wound closure, excision with leaving the path open, deep sacral excision, incision and marsupializare and phenol injection.
Primary closure of wound healing compared with the second time leaving open wound are two main options for chronic pilonidal sinus. Differences between the two processes are identified based on healing and recurrent disease. Although primary closure is an increased potential for wound healing if infection occurred, requiring the patient to reduce the number of activities until the wound is completely healed-10 sapatmini. Failure rate is 16% for healing. Since primary closure does not completely release tension and wound tissue is considered contaminated and debridarii despite excision.
Excision and wound closure technique to the second inteventie require a long period of healing but it is associated with a low rate of appellant. The average healing period of 2 months. Recurrence rate is 8%. Although there are advantages, this method requires constant observation and prolonged wound care Midic.
Marsupializarea technique is a compromise between primary wound closure and secondary closure. The reason is to avoid infection and dehiscence after primary closure, and repeated wound dressing. Marsupializarea patient leaves a wound in the lower diameter. By suturing the wound hole is prevented infection and subcutaneous tissue is recovered, with a shorter healing time. Healing is complete in June sapatamini and recurrence is 4-8%. The patient should continue to keep the wound clean and shave.
Plasty sacrococcigeana Complex wounds requiring extensive excisions are reconstructed using muscle and strip miocutanate. They are less succeptibile infection and have a blood supply that promotes wound healing.