Minimally Invasive Treatment of Pilonidal Disease: Crystallized Phenol and Laser Depilation

Gırgın, Mustafa; Kanat, Burhan Hakan; Ayten, Refik; Çetinkaya, Ziya; Kanat, Zekiye; Bozdağ, Ahmet; Türkoğlu, Ahmet; Ilhan, Yavuz Selim

doi:10.9738/cc130.1

Cited by 46 publications

(45 citation statements)

References 18 publications

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“…Duration of the phenol in the sinus tract is an important factor for success of the application. Many studies have reported the duration of phenol in the sinus as approximately 2-8 min (20,27,31,33). However, in one study, it has been reported that protein structure of the hair was destructed at least 9 min after phenolization (23).…”

Section: Methods Of Phenol Applicationmentioning

confidence: 99%

“…The curettage of the sinus is often done in order to remove granulation tissue (24,31,32). Some authors use a clamp to evacuate the sinus contents, while others clean the sinus with a gauze sponge (11,17,20,22). Cleaning all the sinus content increases the effectiveness and benefits of phenol application.…”

Section: Methods Of Phenol Applicationmentioning

confidence: 99%

“…More frequent follow-up schedules have been reported as 1, 3, 5, 7, 15 days after the operation (16). Some surgeons examine the patients in every 3 weeks (20,24). In some studies, they offer 3 week follow-up periods after 1st, 2nd, and 4th week followups (34).…”

Section: Methods Of Phenol Applicationmentioning

confidence: 99%

“…In a study, low concentrated phenol (%40) has been reported to be as effective as high concentrated phenol (80%), with a lower rate of complications and a faster recovery (19). But most studies indicate that application of high density phenol (%85) yields better results (14,20,22).…”

mentioning

confidence: 99%

“…The answers to these questions have not been clarified in the literature so far. The concentration of phenol solution used in clinical practice varies between 25-80% (15,18,19,20). In addition, several forms of phenol such as cream-gel, liquid and crystalline form can be applied (14,15,19,21).…”

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confidence: 99%

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Treatment of pilonidal disease by phenol application

et al. 2017

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Section: Methods Of Phenol Applicationmentioning

confidence: 99%

Section: Methods Of Phenol Applicationmentioning

confidence: 99%

Section: Methods Of Phenol Applicationmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Treatment of pilonidal disease by phenol application

et al. 2017

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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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Laser Epilation as an Adjunct to Standard Care in Reducing Pilonidal Disease Recurrence in Adolescents and Young Adults

Minneci,

Gil,

Cooper

et al. 2024

JAMA Surg

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ImportanceRecurrence continues to be a significant challenge in the treatment and management of pilonidal disease.ObjectiveTo compare the effectiveness of laser epilation (LE) as an adjunct to standard care vs standard care alone in preventing recurrence of pilonidal disease in adolescents and young adults.Design, Setting, and ParticipantsThis was a single-institution, randomized clinical trial with 1-year follow-up conducted from September 2017 to September 2022. Patients aged 11 to 21 years with pilonidal disease were recruited from a single tertiary children’s hospital.InterventionLE and standard care (improved hygiene and mechanical or chemical depilation) or standard care alone.Main Outcomes and MeasuresThe primary outcome was the rate of recurrence of pilonidal disease at 1 year. Secondary outcomes assessed during the 1-year follow-up included disability days, health-related quality of life (HRQOL), health care satisfaction, disease-related attitudes and perceived stigma, and rates of procedures, surgical excisions, and postoperative complications.ResultsA total of 302 participants (median [IQR] age, 17 [15-18] years; 157 male [56.1%]) with pilonidal disease were enrolled; 151 participants were randomly assigned to each intervention group. One-year follow-up was available for 96 patients (63.6%) in the LE group and 134 (88.7%) in the standard care group. The proportion of patients who experienced a recurrence within 1 year was significantly lower in the LE treatment arm than in the standard care arm (−23.2%; 95% CI, −33.2 to −13.1; P &lt; .001). Over 1 year, there were no differences between groups in either patient or caregiver disability days, or patient- or caregiver-reported HRQOL, health care satisfaction, or perceived stigma at any time point. The LE group had significantly higher Child Attitude Toward Illness Scores (CATIS) at 6 months (median [IQR], 3.8 [3.4-4.2] vs 3.6 [3.2-4.1]; P = .01). There were no differences between groups in disease-related health care utilization, disease-related procedures, or postoperative complications.Conclusions and RelevanceLE as an adjunct to standard care significantly reduced 1-year recurrence rates of pilonidal disease compared with standard care alone. These results provide further evidence that LE is safe and well tolerated in patients with pilonidal disease. LE should be considered a standard treatment modality for patients with pilonidal disease and should be available as an initial treatment option or adjunct treatment modality for all eligible patients.Trial RegistrationClinicalTrials.gov Identifier: NCT03276065

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Minimally Invasive Treatment of Pilonidal Disease: Crystallized Phenol and Laser Depilation

Cited by 46 publications

References 18 publications

Treatment of pilonidal disease by phenol application

Treatment of pilonidal disease by phenol application

Management of Pilonidal Disease

Laser Epilation as an Adjunct to Standard Care in Reducing Pilonidal Disease Recurrence in Adolescents and Young Adults

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