Therapie des Pilonidalsinus und der Acne inversa

Abstract

A pilonidal sinus is a invagination of the skin over the sacrum containing a tuft of hair which enlarges by repeated friction causing the hairs to penetrate the skin. It may become symptomatic if an infection occurs. There are similarities with acne inversa, which is present in about 23% of cases. Acne inversa is an inflammation of the sebaceous glands and terminal hair follicles, chiefly in the intertriginous areas. The first manifestation can occur at any time from puberty to advanced age. 90% of patients are smokers. Initially giant comedones and indolent subcutaneous nodules are found; they progress to form draining sinus tracts. Conservative treatment, incision and/or surgical removal of the abscesses and fistulas is futile. The method of choice is the early complete surgical excision of the involved skin extending into normal tissue both laterally and at the base. In most cases healing of the defects by secondary intention is uneventful.

Morphology of Pilonidal Sinus Disease: Some Evidence of Its Being a Unilocalized Type of Hidradenitis Suppurativa

“…The other histopathological changes revealed in the present study like hair fragments, acute and chronic inflammation agree with earlier descriptions [1,11,14,15,16,17,18]. Studies to date have shown that 23–30% of the patients with HS also suffer from PS [27,28]. For this reason, it is termed an ‘HS-related disorder’ [4,7,8,20,29].…”

Evaluation of open versus closed pilonidal sinus excision in Basrah, Iraq

“…[7][8][9][10] The other studies favored the open method as a treatment of pilonidal sinus and they depend in their conclusion on the higher rate of recurrence that appeared in the closed technique. 11,12 This difference is probably due to the inexperience or other causes of recurrence of pilonidal sinus such as obesity. 13 In present study there was no difference in the recurrence rate in both groups…”

Radiofrequency Pilonidal Sinus Excision: Better Option to Wide Excision and Open Wound Healing Technique

“…Similarly, wound related complications like secondary infection and non-healing was not observed with radiofrequency procedure. Open surgical treatment of pilonidal sinus is reported to have a very high percentage of complete wound healing (3,9,40) . However, in our study, failure of wound healing and recurrence (13%) with this procedure were noticed.…”