Effectiveness of Phenol Application in Pediatric Pilonidal Sinus

Year 2023, Volume: 14 Issue: 4 - Cumhuriyet'in 100. Yılına Armağan Sayısı, 516 - 522, 01.10.2023

Caner İsbir İsa Kıllı Hakan Taşkınlar Ali Naycı

https://doi.org/10.31067/acusaglik.1261052

Abstract

Purpose: Phenol application is an increasingly popular method in the treatment of pediatric pilonidal sinus because of its ease of use. However, there has been insufficient research on standards for phenol application in children. This study aimed to determine standards for evaluating phenol applications to identify parameters that can be used in treatment planning.
Methods: Pediatric patients with pilonidal sinus who underwent surgical excision and/or phenol injection between January 2011 and January 2021 were evaluated retrospectively. Data related to the patients’ age, sex, treatment method (phenol, surgery), number of phenol applications, preoperative complications and antibiotic use, postoperative complications, and treatment duration were analyzed.
Results: The study included 57 patients, 34 boys (59.6%) and 23 girls (40.3%), with a mean age of 15.15±1.62 years (range: 11-18). Number of phenol applications and postoperative complications were significantly higher in patients with prolonged preoperative antibiotic use (>2 weeks) and preoperative complications (p<0.05). Length of hospital stay, wound dressing duration, and time to return to daily routine were significantly shorter in the phenol application group (p<0.001). Treatment duration and frequency of postoperative complications did not differ among the treatment groups (p˃0.05).
Conclusion: This study suggest that phenol application is not superior to surgical treatment in terms of postoperative complications or treatment duration. The potential negative impact of prolonged preoperative antibiotic use and preoperative complications on the treatment process should be considered when deciding to use phenol for the treatment of pilonidal sinus.

Keywords

Children, phenol application, pilonidal sinus, complications

References

• Kayaalp C, Tolan K. Crystallized or Liquid Phenol Application in Pilonidal Sinus Treatment. The Indian Journal of Surgery. 2015;77(6):562-563. DOI: 10.1007/s12262-015-1316-6
• Grabowski J, Oyetunji TA, Goldin AB et al.The management of pilonidal disease: A systematic review. Journal of Pediatric Surgery. 2019:54(11):2210-2221. DOI: 10.1016/j.jpedsurg.2019.02.055
• Arslan S, Okur MH, Basuguy E, et al. Crystallized phenol for treatment of pilonidal sinus disease in children: a comparative clinical study. Pediatric Surgery International. 2021:37(6):807–813. DOI: 10.1007/s00383-020-04798-7
• Calikoglu I, Gulpinar K, Oztuna D, et al. Phenol Injection Versus Excision With Open Healing in Pilonidal Disease: A Prospective Randomized Trial. Diseases of The Colon and Rectum. 2017;60(2):161-169. DOI:10.1097/DCR.0000000000000717
• Olmez, A, Kayaalp C, Aydin C. Treatment of pilonidal disease by combination of pit excision and phenol application. Techniques in Coloproctology. 2013;17(2):201-206. DOI:10.1007/s10151-012-0903-9
• Gecim IE, Goktug UU, Celasin H. Endoscopic Pilonidal Sinus Treatment Combined With Crystalized Phenol Application May Prevent Recurrence. Diseases of The Colon and Rectum. 2017;60(4):405-407. DOI:10.1097/DCR.0000000000000778
• Ates U, Ergun E, Gollu G, et al. Pilonidal sinus disease surgery in children: the first study to compare crystallized phenol application to primary excision and closure. Journal of Pediatric Surgery. 2018;53(3):452-455. DOI:10.1016/j.jpedsurg.2017.05.01
• Mahmood F, Hussain A, Akingboye A. Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment. Annals of Medicine and Surgery. 2020;57:212-217. DOI:10.1016/j.amsu.2020.07.050
• Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Techniques in Coloproctology. 2009;13:189-193. DOI:10.1007/s10151-009-0519-x
• Bi S, Sun K, Chen S, et al. Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis. Scientific Reports. 2020;10(1):13720. DOI:10.1038/s41598-020-70641-7
• Milone M, Velotti N, Manigrasso M, et al. Long-term follow-up for pilonidal sinus surgery: A review of literature with metanalysis. The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2018;16(5):315-320. DOI:10.1016/j.surge.2018.03.009
• Hegge HG, Vos GA, Patka P, et al. Treatment of complicated or infected pilonidal sinus disease by local application of phenol. Surgery. 1987;102(1):52-54.
• Dogru O, Camci C, Aygen E, et al. Pilonidal sinus treated with crystallized phenol: an eight-year experience. Diseases of The Colon and Rectum. 2004;47(11):1934-1938. DOI:10.1007/s10350-004-0720-y
• Yuksel ME. Treatment of pilonidal disease with crystallized phenol has excellent cosmetic results with 80% success rate, but is it safe in pediatric patients? Journal of Pediatric Surgery. 2019;54(10):2191. DOI:10.1016/j.jpedsurg.2019.04.038
• Aksoy HM, Aksoy B, Egemen D. Effectiveness of topical use of natural polyphenols for the treatment of sacrococcygeal pilonidal sinus disease: a retrospective study including 192 patients. European Journal of Dermatology. 2010;20(4):476-481. DOI:10.1684/ejd.2010.0978
• Bruce RM, Santodonato J, Neal MW. Summary review of the health effects associated with phenol. Toxicology and Industrial Health. 1987;3(1):535-568. DOI:10.1177/074823378700300407
• Bayhan Z, Zeren S, Duzgun SA, et al. Crystallized phenol application and modified Limberg flap procedure in treatment of pilonidal sinus disease: A comparative retrospective study. Asian Journal of Surgery. 2016;39(3):172–177. DOI:10.1016/j.asjsur.2015.12.007
• Emiroğlu M, Karaali C, Esin H, et al. Treatment of pilonidal disease by phenol application. Turkish Journal of Surgery. 2017;33(1):5–9. DOI:10.5152/UCD.2016.3532
• Girgin M, Kanat BH, Ayten R, et al. Minimally invasive treatment of pilonidal disease: crystallized phenol and laser depilation. International Surgery. 2012:97(4):288–292. DOI:10.9738/CC130.1
• Stauffer VK, Luedi MM, Kauf P, et al. Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence. Scientific Reports. 2018;8(1):3058. DOI:10.1038/s41598-018-20143-4
• Dag A, Colak T, Turkmenoglu O, et al. Phenol procedure for pilonidal sinus disease and risk factors for treatment failure. Surgery. 2012;151(1):113-117. DOI:10.1016/j.surg.2011.07.015
• Doll D, Friederichs J, Dettmann H, et al. Time and rate of sinus formation in pilonidal sinus disease. International Journal of Colorectal Disease. 2008;23(4):359-364. DOI:10.1007/s00384-007-0389-5
• Topuz O, Sözen S, Tükenmez M, et al. Crystallized phenol treatment of pilonidal disease improves quality of life. The Indian Journal of Surgery. 2014;76(1):81-84. DOI:10.1007/s12262-012-0610-9
• Schneider IH, Thaler K, Köckerling F. Treatment of pilonidal sinuses by phenol injections. International Journal of Colorectal Disease. 1994;9(4):200–202. DOI:10.1007/BF00292250
• Nasr A, Ein SH. A pediatric surgeon's 35-year experience with pilonidal disease in a Canadian children's hospital. Canadian Journal of Surgery Journal Canadien de Chirurgie. 2011;54(1):39-42. DOI:10.1503/cjs.028509
• Johnson EK, Vogel JD, Cowan ML, et al. Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons (2019. The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease. Diseases of The Colon and Rectum. 2019:62(2):146-157. DOI:10.1097/DCR.0000000000001237