A Systematic Review of Fibrin Glue as an Ideal Treatment for the Pilonidal Disease

Win, Myat; Went, Terry R; Ruo, Sheila W; Kannan, Amudhan; Dominic, Jerry Lorren; Sultan, Waleed; Kantamaneni, Ketan; Yanamala, Vijaya Lakshmi; Tara, Anjli; Elshaikh, Abeer O

doi:10.7759/cureus.16831

Cited by 5 publications

(12 citation statements)

References 21 publications

(36 reference statements)

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“…SiLaT is one of the promising techniques of the growing trend toward minimally invasive treatment of SPND, but it needs to be further investigated and validated, which is the main aim of the current study. The demographic characteristics of the patients were similar to those reported in the literature [1,2,[4][5][6]10,12,13].…”

Section: Discussionsupporting

confidence: 73%

“…The worldwide recurrence rate of surgical management of SPND is varied and reported in some studies to be as lower as 0.2%, with the best result achieved using modified Limberg flap [ 2 , 3 ]. Albabtain et al [ 15 ] and Almajid et al [ 16 ] reported a recurrence rate of 22.8% and 7.2%, respectively, for patients treated by surgical excision of SPND in the Kingdom of Saudi Arabia, while Abdelnaby et al [ 5 ] reported zero recurrence rate of sinus lay open technique in Egypt [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sacrococcygeal pilonidal sinus disease (SPND) is an acquired disease with no precise etiopathogenesis. It is mainly related to the recurrent erosion of hair follicles, resulting in a tract or cavity at the natal cleft (the sacrococcygeal region) [1][2][3]. The most common complaints are pain, discharge, bleeding, and itchiness around the sacrococcygeal region.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity, hirsutism, deep gluteal cleft, sitting for several hours per day, and family history are the most reported risk factors [ 3 ]. It is noted that hair removal using laser, depilatory creams, waxing, and shaving was associated with a reduction in the recurrence rate of SPND [ 2 , 3 , 5 ]. For unknown reasons, SPND incidence has been increasing in the past decades.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Sinus Laser Therapy in Sacrococcygeal Pilonidal Sinus Disease: A Single-Center Experience

Zubaidi¹,

Alali²,

Zikry³

et al. 2022

Cureus

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Sacrococcygeal pilonidal sinus disease (SPND) is an acquired chronic disease with no precise etiopathogenesis. The morbidity associated with the disease necessitates the implementation of new techniques, such as sinus laser therapy (SiLaT), to improve disease management. However, surgical techniques as of now are preferred as the mainstay mode of treatment.A retrospective study was conducted to evaluate and report the healing outcome of the application of SiLaT on patients with SPND at a tertiary center. All patients who underwent SiLaT for primary or recurrent pilonidal sinus from February 2012 to December 2019 were included in the study and followed up for at least six months. Forty-one participants (37 males (90.2%) and four females (9.8%)) were included. Of the participants, 58.5% presented with chief complaints of painful swelling with mucopurulent discharge. Most of the participants were students (43.9%). SiLaT was the primary intervention for 82.9% of the participants. The mean duration of hospital stays, resumption of regular activity, and complete wound healing by secondary intention were 30±21.5 hours, 18.4±14.3 days, and 6.5±6.6 weeks, respectively. Around 95.1% of wounds healed without complications. The overall recurrence rate was 24.4%, while the recurrence rate with SiLaT being the primary intervention was 11.8%. Only three (7.32%) patients experienced wound infections as postoperative complications. The visual analog scale (VAS) score decreased postoperatively in the first and second weeks to 3.9±3.2 and 1.9±1.9, respectively, and 78.1% of the total patients showed satisfaction post-surgical interventions. The current study showed that the SiLaT technique is a feasible technology with promising results to evolve. Further studies are encouraged.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Sinus Laser Therapy in Sacrococcygeal Pilonidal Sinus Disease: A Single-Center Experience

Zubaidi¹,

Alali²,

Zikry³

et al. 2022

Cureus

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“…In more recent times, there has been a shift towards less invasive approaches aimed at balancing over/under treatment. These minimally invasive procedures include EPSiT, 11 Gips procedure, 12 sinusectomy, 13 Sinus Laser‐Assisted Closure (SiLaC), 14 and the use of products such as phenol 15 and fibrin glue 16 . These techniques remain in their infancy demonstrating a limited evidence base.…”

Section: Introductionmentioning

confidence: 99%

Long‐term efficacy of endoscopic pilonidal sinus treatment: a single‐centre Australian experience

Hinksman

Naidu

Loon

et al. 2022

ANZ Journal of Surgery

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Background Endoscopic pilonidal sinus treatment (EPSiT) is a novel minimally invasive technique for treating pilonidal sinus disease (PSD) involving endoscopic assessment and treatment. This retrospective, non‐randomized, observational study is the first Australian study of EPSiT and its largest long‐term study to date. Methods From January 2014 to November 2019, 137 patients with PSD underwent EPSiT. Seventy‐two had undergone previous surgery for PSD. Specialized Karl Storz video equipment (fistuloscope) was used. The rigid fistuloscope allowed direct visualization of cavities and secondary tracts. Cavities and tracts were then curetted endoscopically to remove all granulation tissues and hair/follicles. Ablation was then carried out under direct vision along with removal of debris. Patients were then followed up for a mean 56.2 months. Results 72.2% (n = 91) of patients undergoing EPSiT achieved primary healing (needing nil further intervention) at a median of 6 weeks; 13.5% (n = 17) experienced healing followed by recurrence while 14.3% (n = 18) experienced non‐healing. Of the recurrence/non‐healing groups, 20/35 underwent repeat EPSiT with healing occurring in 18/20 patients at a median of 7 weeks. The balance of patients (n = 15) underwent other definitive procedures. The mean operating time was 34 min. There were no major complications and 85% of patients were discharged the same day. Eleven patients were lost to follow‐up. Conclusion EPSiT combines high efficacy of treatment for PSD along with relatively low rates of recurrence. The minimally invasive nature of the procedure means repeat procedures can be performed (where necessary) with low morbidity and a reasonable rate of success.

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Management of Pilonidal Disease

2023

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ImportanceThe management of pilonidal disease continues to be a challenge due to high rates of recurrence and treatment-associated morbidity.ObservationsThere is a heterogeneous repertoire of treatment modalities used in the management of pilonidal disease and wide practice variation among clinicians. Available treatment options vary considerably in their level of invasiveness, associated morbidity and disability, risks of complications, and effectiveness at preventing disease recurrence. Conservative nonoperative management strategies, including persistent improved hygiene, depilation, and lifestyle modification, focus on disease prevention and minimization of disease activity. Epilation techniques using both laser and intense pulse light therapy are also used as primary and adjunct treatment modalities. Other nonoperative treatment modalities include phenol and fibrin injection to promote closure of pilonidal sinuses. The traditional operative management strategy for pilonidal disease involves excision of affected tissue paired with a variety of closure types including primary midline closure, primary off-midline closure techniques (ie, Karydakis flap, Limberg flap, Bascom cleft lift), and healing by secondary intention. There has been a recent shift toward more minimally invasive operative approaches including sinusectomy (ie, trephination or Gips procedure) and endoscopic approaches. Overall, the current evidence supporting the different treatment options is limited by study quality with inconsistent characterization of disease severity and use of variable definitions and reporting of treatment-associated outcomes across studies.Conclusions and RelevancePilonidal disease is associated with significant physical and psychosocial morbidity. Optimal treatments will minimize disease and treatment-associated morbidity. There is a need for standardization of definitions used to characterize pilonidal disease and its outcomes to develop evidence-based treatment algorithms.

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A Systematic Review of Fibrin Glue as an Ideal Treatment for the Pilonidal Disease

Cited by 5 publications

References 21 publications

Outcomes of Sinus Laser Therapy in Sacrococcygeal Pilonidal Sinus Disease: A Single-Center Experience

Outcomes of Sinus Laser Therapy in Sacrococcygeal Pilonidal Sinus Disease: A Single-Center Experience

Long‐term efficacy of endoscopic pilonidal sinus treatment: a single‐centre Australian experience

Management of Pilonidal Disease

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