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Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children

Year 2023, Volume: 11 Issue: 1, 1 - 6, 29.03.2023
https://doi.org/10.21765/pprjournal.1269792

Abstract

Background/Aims: Pilonidal sinus treatment involves surgical excision or flap reconstruction; however, the disease has a high recurrence risk. We determined the outcomes of a modified local application of crystallized phenol.
Methods: In the outpatient clinic, the pilonidal sinus orifices were connected by an incision under local
anesthesia. The hair in the sinus was removed. Then, crystallized phenol was applied. The incision was not
sutured. Daily dressings and baths were recommended.
Results: Crystallized phenol was applied to 50 patients with pilonidal sinus disease (median age = 15 years).
During the follow-up, no bleeding or pain was reported. Recurrence was not found in the follow-ups (one year to
three years).
Conclusions: Surgery has disadvantages such as long-term hospitalization, recurrence risk, and high cost.
Crystallized phenol does not have any of the aforementioned disadvantages. The modified method, in which we
incised and applied crystallized phenol to all sinus tracts, might have also reduced the recurrence.

References

  • 1. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Kao LS, et al. Colon, rectum and anüs.11th ed. Mc-Graw-Hill, United States;2019. p.1320.
  • 2. Grabowski J, Oyetunji TA, Goldin AB, Baird R, Gosain A, Lal DR, et al. The management of pilonidal disease: A systematic review. J Pediatr Surg. 2019; 54(11):2210-21.
  • 3. Søndenaa K, Andersen E, Nesvik I, Søreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995; 10(1):39-42.
  • 4. Oetzmann von Sochaczewski C, Gödeke J. Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany. Int J Colorectal Dis. 2021; 36(10):2135-45.
  • 5. Duman K, Gırgın M, Harlak A. Prevalence of sacrococcygeal pilonidal disease in Turkey. Asian J Surg. 2017; 40(6):434-7.
  • 6. Bubenova M, Mittlboeck M, Kulinna-Cosentini C, Teleky B, Cosentini E. Pilonidal sinus disease: a 25-year experience and long-term results of different surgical techniques. European surgery. 2022; 54:240-8.
  • 7. Ates U, Ergun E, Gollu G, Sozduyar S, Kologlu M, Cakmak M, et al. Pilonidal sinus disease surgery in children: the first study to compare crystallized phenol application to primary excision and closure. J Pediatr Surg. 2018; 53(3):452-5.
  • 8. Gönüllü D, Gedik ML, Ilgun AS, Er AM, Öner Z, Keskin M, et al. Comparison of Pilonidal Sinus Repair Techniques: Phenol Application After Minimal Surgical Excision and Flap Repair. JAREM 2018; 8(3): 133-7.
  • 9. Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Tech Coloproctol. 2009; 13(3):189-93.
  • 10. Baltrak YA, Söğüt SE, Varlıklı O. Çocuklarda pilonidal sinüs hastalığı tedavisinde kristalize fenol uygulaması sonuçları tek merkez deneyimlerimiz. Çoc Cer Derg. 2021; 35:65–70.
  • 11. Albabtain IT, Alkhaldi A, Aldosari L, Alsaadon L. Pilonidal sinus disease recurrence at a tertiary care center in Riyadh. Ann Saudi Med. 2021; 41(3):179-85.
  • 12. Arslan S, Okur MH, Basuguy E, Aydogdu B, Zeytun H, Cal S, et al. Crystallized phenol for treatment of pilonidal sinus disease in children: a comparative clinical study. Pediatr Surg Int. 2021; 37(6):807-13.
  • 13. Dogru O, Kargin S, Turan E, Kerimoğlu RS, Nazik EE, Ates D. Long-term outcomes of crystallized phenol application for the treatment of pilonidal sinus disease. J Dermatolog Treat. 2022; 33(3):1383-90.
  • 14. Madenci H, Uysal M. Risk factors for recurrence after pilonidal sinus surgery in children and adolescents. S Afr J Surg. 2021 Jun;59(2):62-64.
  • 15. Şengül S, Güler Y, Çalış H, Kubat M, Karabulut Z. Crystallized phenol treatment vs excision and primary closure in pilonidal sinus disease: A randomized clinical trial in adolescent patients. J Pediatr Surg. 2022; 57(3):513-7.
  • 16. Iesalnieks I, Ommer A, Herold A, Doll D. German National Guideline on the management of pilonidal disease: update 2020. Langenbecks Arch Surg. 2021;406(8):2569-80.
  • 17. Yuksel ME. Treatment of pilonidal disease with crystallized phenol has excellent cosmetic results with 80% success rate, but is it safe in pediatric patients?. J Pediatr Surg. 2019; 54(10):2191.
  • 18. Dag A, Colak T, Turkmenoglu O, Sozutek A, Gundogdu R. Phenol procedure for pilonidal sinus disease and risk factors for treatment failure. Surgery. 2012; 151(1):113-7.
  • 19. Kaymakcioglu N, Yagci G, Simsek A, Unlu A, Tekin OF, Cetiner S, et al. Treatment of pilonidal sinus by phenol application and factors affecting the recurrence. Tech Coloproctol. 2005; 9(1):21-4.
  • 20. 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. Eur J Dermatol. 2010; 20(4):476-81.
  • 21. Kurt F. The comparison of crystallized phenol with lateral flap method in treatment of sinus pilonidalis. East J Med 2019; 24:422–6.
  • 22. Yuksel ME. Pilonidal Disease can be Treated by Dermatologists with Crystallised Phenol in Outpatient Clinics. J Coll Physicians Surg Pak. 2020; 30(7):772-3.
  • 23. Hagiga A, Aly M, Gultiaeva M, Murphy H. Using phenol for treating pilonidal sinus: a systematic review and meta-analysis. Eur J Plast Surg. 2019; 42:223–30.

Çocuklarda Pilonidal Sinüs Tedavisinde Minimal İnvaziv Kristalize Fenol Uygulamasının Etkinliği

Year 2023, Volume: 11 Issue: 1, 1 - 6, 29.03.2023
https://doi.org/10.21765/pprjournal.1269792

Abstract

Arka Plan/Amaçlar: Pilonidal sinüs tedavisi, cerrahi eksizyon veya flep rekonstrüksiyonunu içerir; ancak hastalığın tekrarlama riski oldukça yüksektir. Çocuklarda kristalize fenolün modifiye edilmiş lokal uygulamasının sonuçlarını sunmayı hedefledik.
Yöntemler: Poliklinik şartlarında pilonidal sinüs ağızları lokal anestezi yapıldıktan sonra bir insizyonla birleştirildi.
Sinüsteki kıllar temizlendi. Daha sonra kristalize fenol uygulandı. Sinüs ağızlarına yaptığımız insizyon sütüre edilmedi. Günlük pansuman ve banyo önerildi.
Bulgular: Pilonidal sinüs hastalığı olan 50 çocuk hastaya (medyan yaş = 15 yıl) kristalize fenol uygulandı.
Takiplerinde kanama ve ağrı şikayeti olmadı. Takiplerde nüks saptanmadı (1-3 yıl)
Sonuç: Cerrahinin uzun süreli hastanede kalış süresi, nüks riski ve yüksek maliyet gibi dezavantajları vardır.
Kristalize fenol yukarıda belirtilen dezavantajların hiçbirine sahip değildir. Değiştirdiğimiz yöntem,
tüm sinüs yollarına kesilip kristalize fenol uygulanması olup nüksü de azaltmış olabilir.

References

  • 1. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Kao LS, et al. Colon, rectum and anüs.11th ed. Mc-Graw-Hill, United States;2019. p.1320.
  • 2. Grabowski J, Oyetunji TA, Goldin AB, Baird R, Gosain A, Lal DR, et al. The management of pilonidal disease: A systematic review. J Pediatr Surg. 2019; 54(11):2210-21.
  • 3. Søndenaa K, Andersen E, Nesvik I, Søreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995; 10(1):39-42.
  • 4. Oetzmann von Sochaczewski C, Gödeke J. Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany. Int J Colorectal Dis. 2021; 36(10):2135-45.
  • 5. Duman K, Gırgın M, Harlak A. Prevalence of sacrococcygeal pilonidal disease in Turkey. Asian J Surg. 2017; 40(6):434-7.
  • 6. Bubenova M, Mittlboeck M, Kulinna-Cosentini C, Teleky B, Cosentini E. Pilonidal sinus disease: a 25-year experience and long-term results of different surgical techniques. European surgery. 2022; 54:240-8.
  • 7. Ates U, Ergun E, Gollu G, Sozduyar S, Kologlu M, Cakmak M, et al. Pilonidal sinus disease surgery in children: the first study to compare crystallized phenol application to primary excision and closure. J Pediatr Surg. 2018; 53(3):452-5.
  • 8. Gönüllü D, Gedik ML, Ilgun AS, Er AM, Öner Z, Keskin M, et al. Comparison of Pilonidal Sinus Repair Techniques: Phenol Application After Minimal Surgical Excision and Flap Repair. JAREM 2018; 8(3): 133-7.
  • 9. Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Tech Coloproctol. 2009; 13(3):189-93.
  • 10. Baltrak YA, Söğüt SE, Varlıklı O. Çocuklarda pilonidal sinüs hastalığı tedavisinde kristalize fenol uygulaması sonuçları tek merkez deneyimlerimiz. Çoc Cer Derg. 2021; 35:65–70.
  • 11. Albabtain IT, Alkhaldi A, Aldosari L, Alsaadon L. Pilonidal sinus disease recurrence at a tertiary care center in Riyadh. Ann Saudi Med. 2021; 41(3):179-85.
  • 12. Arslan S, Okur MH, Basuguy E, Aydogdu B, Zeytun H, Cal S, et al. Crystallized phenol for treatment of pilonidal sinus disease in children: a comparative clinical study. Pediatr Surg Int. 2021; 37(6):807-13.
  • 13. Dogru O, Kargin S, Turan E, Kerimoğlu RS, Nazik EE, Ates D. Long-term outcomes of crystallized phenol application for the treatment of pilonidal sinus disease. J Dermatolog Treat. 2022; 33(3):1383-90.
  • 14. Madenci H, Uysal M. Risk factors for recurrence after pilonidal sinus surgery in children and adolescents. S Afr J Surg. 2021 Jun;59(2):62-64.
  • 15. Şengül S, Güler Y, Çalış H, Kubat M, Karabulut Z. Crystallized phenol treatment vs excision and primary closure in pilonidal sinus disease: A randomized clinical trial in adolescent patients. J Pediatr Surg. 2022; 57(3):513-7.
  • 16. Iesalnieks I, Ommer A, Herold A, Doll D. German National Guideline on the management of pilonidal disease: update 2020. Langenbecks Arch Surg. 2021;406(8):2569-80.
  • 17. Yuksel ME. Treatment of pilonidal disease with crystallized phenol has excellent cosmetic results with 80% success rate, but is it safe in pediatric patients?. J Pediatr Surg. 2019; 54(10):2191.
  • 18. Dag A, Colak T, Turkmenoglu O, Sozutek A, Gundogdu R. Phenol procedure for pilonidal sinus disease and risk factors for treatment failure. Surgery. 2012; 151(1):113-7.
  • 19. Kaymakcioglu N, Yagci G, Simsek A, Unlu A, Tekin OF, Cetiner S, et al. Treatment of pilonidal sinus by phenol application and factors affecting the recurrence. Tech Coloproctol. 2005; 9(1):21-4.
  • 20. 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. Eur J Dermatol. 2010; 20(4):476-81.
  • 21. Kurt F. The comparison of crystallized phenol with lateral flap method in treatment of sinus pilonidalis. East J Med 2019; 24:422–6.
  • 22. Yuksel ME. Pilonidal Disease can be Treated by Dermatologists with Crystallised Phenol in Outpatient Clinics. J Coll Physicians Surg Pak. 2020; 30(7):772-3.
  • 23. Hagiga A, Aly M, Gultiaeva M, Murphy H. Using phenol for treating pilonidal sinus: a systematic review and meta-analysis. Eur J Plast Surg. 2019; 42:223–30.
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Sabriye Dayı 0000-0002-0643-3785

Serpil Sancar 0000-0001-5464-8695

Meryem Anayurt 0000-0001-8477-6751

Publication Date March 29, 2023
Acceptance Date March 27, 2023
Published in Issue Year 2023 Volume: 11 Issue: 1

Cite

Vancouver Dayı S, Sancar S, Anayurt M. Efficacy of Minimally Invasive Crystallized Phenol Application in the Treatment of Pilonidal Sinus in Children. pediatr pract res. 2023;11(1):1-6.