The Sharp End of Pilonidal Disease

Gosselink, M.; Ctercteko, Grahame

doi:10.1097/dcr.0000000000000989

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…interestingly, Gosselink -using electron methods -could depict hair just entering the skin in 2017, thus proving that sharp hair with "right" directional scales was the culprit, that penetrated into deeper skin [24,25]. Ruptured hair, as as hair with its root, are too large and too bulky at the end to enter the skin, which could be demonstrated by Bosche [20].…”

Section: The Most Likely Reason Pilonidal Sinus Diseasementioning

confidence: 98%

The Origin of Pilonidal Sinus Disease – 10 wrong Theories and one Recent Discovery

Dettmer

Degiannis

Braun-Münker

et al. 2023

AJTES

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Introduction: In the last two centuries, many theories have been proposed to explain the origin of pilonidal sinus disease (PSD) – congenital and acquired. Materials and Methods: A PubMed literature review was conducted and looked at different proposed theories on the origin of PSD; this overview was then compared to research results from more recent studies. Results: Initially it was postulated, that PSD was of embryonic origin. This however changed during World War II as more 78.000 American soldiers were diagnosed and treated for PSD. Thereafter, the perception of the origin of PSD changed to an acquired one. New data has shown that short hair fragments, which have fallen from the scalp may be the origin of PSD – therefore disproving the theory of folliculitis and fatty gland obstruction. Conclusion: These new findings may explain why recurrences/new diseases occur within follicle-free areas – such as scars and without any preceding infection. This may aid in the prevention of PSD.

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Section: The Most Likely Reason Pilonidal Sinus Diseasementioning

confidence: 98%

The Origin of Pilonidal Sinus Disease – 10 wrong Theories and one Recent Discovery

Dettmer

Degiannis

Braun-Münker

et al. 2023

AJTES

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“…Recent studies have shown that sharp hair fragments constitute the primary component of the pilonidal sinus nest [10]; particularly from the occiput [11]. Electron microscopy images [12] have captured hair strands erecting themselves and piercing the skin of the upper (cranial) IGF when a sharp edge is in proximity and hair scales point away from the skin. A hairy IGF seems to hold hair longer into position, explaining that hairy individuals appear to have a higher susceptibility to PSD.…”

Section: Introductionmentioning

confidence: 99%

A Single-Center Prospective Comparison of Natal Cleft Depth of 200 Patients with and without Pilonidal Sinus Disease

Maak,

Doll,

Bari

et al. 2023

WJS

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The etiology of primary pilonidal sinus disease (PSD) remains unclear. Current understanding suggests that sharp hair fragments from the occiput contribute to the formation of PSD. In 2009, Akinci et al. reported a correlation between PSD and a deeper natal cleft. We investigated the association between intergluteal fold (IGF) depth and PSD risk using a standardized five-step measuring protocol. Our study included 95 PSD patients and 105 non-PSD individuals, and measurements were taken from the glabella sacralis to the anus in a controlled in-house setting after obtaining informed consent from voluntary participants of a northern German population. The mean (± SD) intergluteal depth progressively increased from the intergluteal opening at the glabella sacralis at 9.1 (± 3.4) mm to a maximum of 62.6 (± 10.4) mm. Notably the deepest point was consistently observed at the anus, where PSD occurence is rare. No significant difference in intergluteal fold depth between PSD and non-PSD patients was found. Additionally, PSD predominantly developed in the proximal (cranial) third of the intergluteal fold, despite the maximum depth being in the distal region. These findings suggest that intergluteal fold depth is not a risk factor for PSD.

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“…[3] in 2017, Gosselink M. and Ctercteko G. depicted on electron microscopy how hair pierces into the skin if the scale direction is outright. [4,5] Bosche F. et al could show that the pilonidal nest contains mainly rootless short hair fragments of mostly less than 1 cm in length, which pierce into the skin. [6] These hairs have been falling from the head into the intergluteal crest.…”

mentioning

confidence: 99%

Surgical Treatment of Uncomplicated Pilonidal Sinus with the Simple Closed Technique - New Findings of Pilonidal Sinus Treatment from Albania.

Dettmer,

Doll,

Maak

2024

AJTES

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Dear Editor, Concerning the article of Bollano E et al. “Surgical treatment of uncomplicated Pilonidal Sinus with a simple closed technique” has been gathering our attention. In this LTE, we would like to critically discuss some of the author's statements. Firstly, the stated pathophysiology of PSD is an outdated theory. Furthermore, primary midline closure, as postulated by the author, is not the surgical procedure of first choice, as several large reviews have shown. The letter discusses the rationale behind adopting the simple closed technique, highlighting its efficacy and potential advantages. By presenting data from our experiences in Albania, we aim to contribute valuable insights to the global discourse on pilonidal sinus treatment. This letter is a noteworthy addition to AJTES, offering fresh insights into the treatment landscape of pilonidal sinus. We trust the editorial team will find the content aligned with the journal's objectives and scope. Your consideration of this submission is highly appreciated, and we look forward to the possibility of contributing to the journal's ongoing dialogue on innovative surgical approaches.

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The Sharp End of Pilonidal Disease

Cited by 5 publications

References 4 publications

The Origin of Pilonidal Sinus Disease – 10 wrong Theories and one Recent Discovery

The Origin of Pilonidal Sinus Disease – 10 wrong Theories and one Recent Discovery

A Single-Center Prospective Comparison of Natal Cleft Depth of 200 Patients with and without Pilonidal Sinus Disease

Surgical Treatment of Uncomplicated Pilonidal Sinus with the Simple Closed Technique - New Findings of Pilonidal Sinus Treatment from Albania.

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