The presence of occipital hair in the pilonidal sinus cavity—a triple approach to proof

Doll, Dietrich; Bosche, Friederike; Hauser, Alain; Moersdorf, P.; Sinicina, Inga; Grunwald, J.; Reckel, Frank; Luedi, Markus M.

doi:10.1007/s00384-018-2988-8

Cited by 27 publications

(32 citation statements)

References 22 publications

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“…2 They acknowledge that stronger, razor-sharp cut hairs from the head (as seen in Figure 1), accumulating between the buttocks and piercing the healthy skin, 3 may be the source of pilonidal sinus disease. 4,5 We agree with the majority of conclusions in the guidelines, but several topics are controversial at best.…”

Section: New Attempt To Reach a Common Sense In Pilonidal Sinus Therapysupporting

confidence: 69%

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

Doll

Luedi

2019

Diseases of the Colon &Amp; Rectum

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To the Editor-In his letter, Dr Tomassi describes his study from Kaiser Permanente Southern California, in which the investigators "expectantly managed" 378 patients with high-grade anal dysplasia, demonstrating an incidence rate of 0.19% per patient-year for anal squamous cell carcinoma (SCC). This rate is lower than the rate we identified using the population-based cancer registries of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. It must be emphasized that Dr Tomassi's data derive from Kaiser Permanente billing codes, and therefore all included patients are medically insured. As Dr Tomassi states in his letter, surveillance of patients at high risk for anal SCC is provided by "general and colorectal surgeons, infectious disease specialists, family medicine and internal medicine physicians, and gynecologists." The Kaiser Permanente data come from a large integrated managed care group that receives high marks for quality of care with an emphasis on preventive care and access to care. This likely represents a higher level of longitudinal care than most patients in the United States are fortunate enough to receive. Our SEER data are derived from 34.6% of the US population, irrespective of insurance status, and are Data from different sources have different applications: for a large healthcare system or insurance organization looking to allocate resources and determine policy for a population, we commend the use of the Kaiser data. For a surgical practitioner counseling his or her patients, we commend data such as our own. We share with our crosstown colleagues the clinical conclusion that expectant management of HSIL is reasonable, based on evidence and experience. We wonder if we can now call it San Diego rather than expectant management, to use a sunnier and less pregnant term! We also share with everyone in the field, including advocates of HSIL ablation with whom we disagree, the conviction that people at high risk for anal cancer should be followed regularly by practitioners accustomed to examining the anus. Indurated or ulcerated lesions should be biopsied so that early stage cancers can be detected and cured.

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Section: New Attempt To Reach a Common Sense In Pilonidal Sinus Therapysupporting

confidence: 69%

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

Doll

Luedi

2019

Diseases of the Colon &Amp; Rectum

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“…There is increasing evidence that geographical location may contribute to recurrence rate and therapy efficacy (18), as well as social and familial factors (24)(25)(26)(27). The large burden of patients has encouraged Turkish surgeons to publish research on the factors contributing to greater PSD incidence (23), such as cut hair removal (28)(29)(30) as well as regular showering (31,32). New methods have been proposed (33)(34)(35), classifications defined, systematic reviews compiled (36) and rarities published (37)(38)(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

Turkey is leading in the 21st century pilonidal sinus disease research

et al. 2020

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Objective: Pilonidal sinus disease (PSD) has been a recognized pathology for the past 188 years. We studied whether scientific interest in this common disease has grown or declined over time. Our investigation included analysis of the world literature between 1833 and 2018. Material and Methods: A PubMed search was conducted to identify all publications on pilonidal sinus disease, broken down by country, year of publication and number of patients included or described. Results: The number of patients studied has been increasing, with date of more than 10,000 patients published per decade since 1970, and the total number of affected patients exceeding n= 40.000 in 2010 and Turkey leads the research, contributing 39% of the Mediterranean patients and 18% of the patients globally, while Italy provides 26% of the Mediterranean patients and 12% of the global total. Flap studies have increased, whereas primary open treatment studies have decreased from 40% in 1940 to less than 10% at present. Twenty percent of the studies performed today report primary median approaches, and the number of randomized controlled trials has increased. Conclusion: Surgeons in Turkey currently publish the lion´s share of the pilonidal sinus literature.

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“…Die Arbeitsgruppe von Doll und Kollegen konnte auch nachweisen, dass diese Büschel von Haaren (▶ Abb. 1) am ehesten von der Kopfhaut im Rahmen von Haarschnitt in die Rima ani gelangen [6]. Des Weiteren spielt die Qualität der Haare eine wichtige Rolle, insbesondere kräftiges unflexibles Haar mit starkem Wuchs nicht nur an der Kopfhaut begünstigt offensichtlich die Entstehung des Pilonidalsinus.…”

Section: Pathomechanismusunclassified

Sinus pilonidalis – was ist die beste chirurgische Therapie?

Petersen

2019

Zentralbl Chir

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Zusammenfassung Einleitung Der Sinus pilonidalis ist eine meist chronische punktuelle Infektion der behaarten Haut im Bereich von Hautfalten mit der häufigsten Lokalisation im Bereich der Rima ani. Die Erkrankung hat oft erhebliche Auswirkung auf die Lebensqualität der Betroffenen, die Behandlung kann komplex sein und muss dem Patientenbedarf angepasst werden. Methoden Im Folgenden wird eine Übersicht über die Entstehung sowie die Behandlungsalternativen und deren Besonderheiten gegeben. Dabei werden jeweils die Aspekte frühe postoperative Ergebnisse, Wundheilungsstörung und Langzeitergebnisse dargestellt. Ergebnisse Der Pathomechanismus der Pilonidalsinus-Erkrankung ist weiterhin nicht abschließend geklärt, es muss auch weiterhin davon ausgegangen werden, dass die Haare in der Rima ani wesentlich zu Entstehung beitragen. Neuere Erkenntnisse weisen jedoch darauf hin, dass die großen Haarbüschel, die immer wieder in der Wundhöhle gefunden werden, am ehesten von der behaarten Kopfhaut stammen. Es lassen sich im Wesentlichen 3 Gruppen der Behandlungsoptionen unterscheiden: Die Standardbehandlung der Exzision und die folgende offene Wundbehandlung hat eine geringe Rezidivrate, weist jedoch erheblichen Aufwand im Rahmen der Wundbehandlung auf und führt dadurch zu langer Krankheitsdauer. Relativ neu in den Fokus geraten sind die lokal destruierenden Behandlungsverfahren, welche die Haut im Wesentlichen erhalten. Wichtige Vertreter sind das sog. Pit Picking, Fistuloskopie und andere Behandlungsformen wie Phenolinjektion oder Laserbehandlung. Bei diesen Behandlungsmöglichkeiten steht die abschließende Bewertung der Ergebnisse noch aus. Die 3. Behandlungsgruppe umfasst die Exzision und plastisch-rekonstruktive Verfahren. Diese Verfahren sind technisch aufwendig, gehen häufig mit stationärer Behandlung einher und führen langfristig jedoch zu relativ guten Ergebnissen. Schlussfolgerung Die Pilonidalsinus-Behandlung erfordert eine am Patienten orientierte Therapieplanung. Dabei müssen dem Patienten die unterschiedlichen Behandlungsoptionen vermittelt werden und eine Behandlungsempfehlung muss ausgesprochen werden. Hier dient die Exzision und offene Wundbehandlung weiterhin als Standardverfahren, anhand dessen die Vor- bzw. Nachteile der anderen Behandlungsoptionen vermittelt werden können.

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The presence of occipital hair in the pilonidal sinus cavity—a triple approach to proof

Cited by 27 publications

References 22 publications

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

Turkey is leading in the 21st century pilonidal sinus disease research

Sinus pilonidalis – was ist die beste chirurgische Therapie?

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