Crystallized phenol treatment vs excision and primary closure in pilonidal sinus disease: A randomized clinical trial in adolescent patients

Şengül, Serkan; Güler, Yılmaz; Çalış, Hasan; Kubat, Mehmet; Karabulut, Zülfikar

doi:10.1016/j.jpedsurg.2021.03.004

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Following this article, Yüksel (17) stated in his letter to the editor that it should not be used in children yet, citing Germany as an example. Otherwise, the feasibility of phenol application has been shown in the literature in other studies, including application in the children group, and no severe side effects have been encountered were reported (7,15,(18)(19)(20).…”

Section: Discussionmentioning

confidence: 86%

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Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children

Dayı

Sancar

ANAYURT>

2023

Pediatric Practice and Research

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Background/Aims: Pilonidal sinus treatment involves surgical excision or flap reconstruction; however, the disease has a high recurrence risk. We determined the outcomes of a modified local application of crystallized phenol. Methods: In the outpatient clinic, the pilonidal sinus orifices were connected by an incision under local anesthesia. The hair in the sinus was removed. Then, crystallized phenol was applied. The incision was not sutured. Daily dressings and baths were recommended. Results: Crystallized phenol was applied to 50 patients with pilonidal sinus disease (median age = 15 years). During the follow-up, no bleeding or pain was reported. Recurrence was not found in the follow-ups (one year to three years). Conclusions: Surgery has disadvantages such as long-term hospitalization, recurrence risk, and high cost. Crystallized phenol does not have any of the aforementioned disadvantages. The modified method, in which we incised and applied crystallized phenol to all sinus tracts, might have also reduced the recurrence.

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Section: Discussionmentioning

confidence: 86%

“…When we compared our study with the reported phenol applications in the literature, the number of pilonidal sinus orifices reported for phenol applications in other studies were either unspecified (7,15) or less than 3 (10). The number of pilonidal sinus orifices influences recurrence.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children

Dayı

Sancar

ANAYURT>

2023

Pediatric Practice and Research

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“…Of the 7 patients in whom recurrence was detected, the average presentation time for recurrence was 5.8 months (1–10). For two of the 7 patients with recurrence, open surgery with a Karydakis flap, and 5 patients under local anesthesia, crystallized phenol was applied as described by Şengül et al [ 6 ].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic pilonidal sinus treatment (EPSIT) versus sinus laser therapy (SiLaT) for sacrococcygeal pilonidal sinus.

Ersavas¹,

Erginel²,

Yanar³

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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Introduction: New surgical treatment methods are being investigated in sacrococcygeal pilonidal sinus disease. Minimal invasive methods such as endoscopic pilonidal sinus treatment (EPSIT) and sinus laser therapy (SiLaT) have promising results and advantages of laparoscopic surgery. Aim: To compare the efficiency and safety of EPSIT with SiLaT. Material and methods: Seventy-three patients with pilonidal sinus who had undergone EPSIT or SiLaT within two years were evaluated retrospectively. Data of patients' demographics, complications and postoperative course were collected and compared between the two groups. Results: We analyzed seventy-three patients who underwent EPSIT or SiLaT, with a mean age of 23.4 ±8.4 (12-46) years and body mass index (BMI) of 25.5 ±4.5 (18-38) kg/m 2 . Among them, 36 patients (26 males, ten females) underwent EPSIT and 37 patients (27 males, ten females) underwent SiLaT. Mean operative time was similar for both groups (32.3 ±14.8 vs. 31.0 ±14.8; p = 0.757). Early complications (minimal bleeding) were recorded in two patients in the SiLaT group. The duration of analgesic use was significantly lower in the EPSIT group compared to the SiLaT group (1.3 ±0.5 (1-3) vs. 1.9 ±1.1 (1-5); p = 0.005). The mean postoperative time of total wound healing was similar for both groups: 23.6 ±14.7 (12-90) vs. 25.2 ±14.5 (14-90) days (p = 0.385). There was no significant difference in the average time of return to total daily activity (3.4 ±0.9 (2-5) vs. 3.6 ±1.2 (2-7) days, p = 0.679). There were no significant differences between the groups regarding late postoperative complications (recurrence: 7). Conclusions: Both methods have similar early and late complications. The duration of need for analgesic usage was shorter in EPSIT patients.

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“…A pediatric retrospective cohort study using crystallized phenol demonstrated a 9% recurrence rate at 3-month follow-up. When comparing phenol injection with excision with primary closure, 2 studies demonstrated nonsignificantly lower recurrence rates in patients who underwent phenol application. Finally, a study evaluating patients undergoing 6 to 8 laser treatments followed by phenol injection demonstrated no recurrences at a mean follow-up of 24 months …”

Section: Introductionmentioning

confidence: 99%

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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Crystallized phenol treatment vs excision and primary closure in pilonidal sinus disease: A randomized clinical trial in adolescent patients

Cited by 7 publications

References 23 publications

Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children

Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children

Endoscopic pilonidal sinus treatment (EPSIT) versus sinus laser therapy (SiLaT) for sacrococcygeal pilonidal sinus.

Management of Pilonidal Disease

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