Use of crystallized phenol in pilonidal sinus, in the pediatric age group, 5-year single surgeon experience

Abstract

Abstract Objective: The Pilonidal Sinus (PS) is a pathology of the gluteal cleft that occurs with acute or chronic infection. This study aimed to report the evaluation of five-year experience with 50 patients’ data outcomes of crystallized phenol in pilonidal sinus treatment (CP) pediatric age group. Methods: This retrospective study included 50 patients who underwent CP between 2017 and 2023 years. Patient demographics, operative data, follow-up findings, complications, and recurrence data were also evaluated. Results: Fifty patients (female:31, male:19), mean of age 15,4 years. Hirsutism was diagnosed in 10 female patients (20%). Sixteen (32 %) patients had a family history of PS. Five patients had a smoking habit history (%10). The form of anesthesia was local anesthesia in eight patients (16%), sedation and local anesthesia in 27 patients (54%), and spinal anesthesia in 15 patients (30%). The average duration of the procedure was 13,8 min (10–22 minutes). The mean postoperative leakage time were 6,6 days. Complications were observed in five patients. (10%). Recurrence was observed in three patients (6%). The overall cure rate is 94%. Conclusion: The CP procedure should be used as the first choice, especially in adolescents, compared to the primary method in PS, such as total sinus excision, due to its minimally invasive, painless, low risk of recurrence, and very short postoperative recovery time.

Keywords

• pilonidal sinus
• crystallized phenol
• minimally invasive surgery
• recurrence
• complication

Project Number

1

References

1. Hodges RM. Pilonidal sinus. Boston Med Surg J. 1880; 103: 485-586.
2. Tezel E., Bostancı H., Azılı C., Kurukahvecioğlu O., Anadol Z. A new perspective for pilonidal sinüs disease and its treatment. Marmara Medical Journal. 2009;22:85-9.
3. Sondenaa K, Andersen E, Nesvik I, Soreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995;10(1):39-42.
4. Nasr A, Ein SH. A pediatric surgeon’s 35-year experience with pilonidal disease in a Canadian children’s hospital. Can J Surg. 2011;54(1):39-42. doi: 10.1503/cjs.028509.
5. Akan K, Tihan D, Duman U, Özgün Y, Erol F, Polat M. Comparison of surgical Limberg flap technique and crystallized phenol application in the treatment of pilonidal sinus disease: a retrospective study. Ulus Cerrahi Derg. 2013;29(4):1626. doi:10.5152/UCD.2013.2457.
6. Maurice BA, Greenwood RK. A conservative treatment of pilonidal sinus. Br J Surg 1964;51:510-2. doi: 10.1002/bjs.1800510711.
7. Doll D, Orlik A, Maier K, Kauf P, Schmid M, Diekmann M, Vogt AP, Stauffer VK, Luedi MM. Impact of geography and surgical approach on recurrence in global pilonidal sinus disease. Sci Rep. 2019;22;9(1):15111. doi: 10.1038/s41598-019-51159-z.
8. Stauffer VK, Luedi MM, Kauf P, Schmid M, Diekmann M, Wieferich K, Schnüriger B, Doll D. Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence. Sci Rep. 2018;15;8(1):3058. doi: 10.1038/s41598-018-20143-4.

9. Dogru O, Camci C, Aygen E, Girgin M, Topuz O. Pilonidal sinus treated with crystallized phenol: an eight-year experience. Dis Colon Rectum. 2004;47(11):1934-8. doi: 10.1007/s10350-004-0720-y.
10. Fahrni GT, Vuille-Dit-Bille RN, Leu S, et al. Five-year follow-up and recurrence rates following surgery for acute and chronic pilonidal disease: A survey of 421 cases. Wounds. 2016;28:20-6.
11. American Society of Colorectal Surgeons. Pilonidal disease. Available from: https://www.fascrs.org/patients/diseasecondition/pilonidaldisease.
12. Yildiz T, Elmas B, Yucak A, Turgut HT, Ilce Z. Risk Factors for Pilonidal Sinus Disease in Teenagers. Indian J Pediatr. 2017;84(2):134-8. doi:10.1007/s12098-016-2180-5.
13. 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. J Pediatr Surg 2017;53(3):452-5.
14. Yuksel ME. Pilonidal sinus disease can be treated with crystallized phenol using a simple three-step technique. Acta Dermatovenerol Alp Pannonica Adriat. 2017;26:15-7.