S-shaped wide excision with primary closure for extensive chronic pilonidal sinus disease.

Kerem Karaman,Sait Murat Dogan,Cengiz Aydin,Mutlu Unver,Eyup Kebapcı,Cem Tugmen,Safak Ozturk,Mustafa Olmez

doi:10.1155/2014/451869

Kerem Karaman, Sait Murat Dogan + Show 6 more

Open Access

https://doi.org/10.1155/2014/451869

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Abstract

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years. Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient's postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups. Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.

Highlights

pilonidal sinus disease (PSD) is a debilitating, painful, chronic inflammatory disease that is caused by penetration of the skin by loose hair
We report on a case with a complex chronic PSD to which we applied primary closure after an S-shaped wide excision
After resection of the pilonidal cyst and the sinus tracts (Figure 3(a)), a relaxation incision was made by incising the gluteus muscle fascia vertically on either side, which allowed rotation of the skin and the underlying tissue for tension-free primary closure

Summary

Background

The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient’s postoperative course was uneventful, and at the end of one-year followup he is disease-free and comes for routine checkups. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion

Introduction

Case Report

Findings

Discussion