Pilonidal Disease Treatment with Pit Excision and Silver Nitrate (A Retrospective Study)

Document Type : Research/Original Article

Authors

Inonu University, General Surgery Department, Malatya, Turkey

10.30476/acrr.2024.100989.1198

Abstract

Objective
Minimally invasive treatment approaches for pilonidal disease have been described as controlled tissue damage of the sinus cavity via chemical agents or lasers. Although silver is a widely used chemical for healing wounds, there are limited studies about pilonidal disease management. The aim of this study was to evaluate the efficacy of silver nitrate on pilonidal disease.
Patients and Methods
Patients who were diagnosed with pilonidal disease were treated with silver nitrate application. Silver nitrate was applied in the sinus tract following the excision of the sinus orifice with a small incision and debridement of the sinus cavity. Silver nitrate sticks were used to obtain controlled damage in the tissue of the sinus cavity for three sessions on the 0, 1st, and 7th days.
Results
Forty-two patients with pilonidal disease were included in this study, and silver nitrate treatment was applied in our institute. The median age of the patients was 24 (16-56), and all of the treatment procedures were applied in the operating room. Thirthy-one of the patients (78.6%) was accepted as treated at the end of the 12-month follow-up duration.
Conclusions
Silver nitrate treatment is a simple, safe, and inexpensive minimally invasive treatment technique for pilonidal disease. This treatment can be an alternative treatment choice to other minimally invasive techniques. It is easy to perform in outpatient clinics, and the results of this study might be promising.

Keywords

References

  1.  

    1. Bolandparvaz S, Moghadam Dizaj P, Salahi R, Paydar S, Bananzadeh M, Abbasi HR, et al. Evaluation of the risk factors of pilonidal sinus: A single-center experience. Turk J Gastroenterol. 2012;23:535–7.
    2. Akinci ÖF, Bozer M, Uzunköy A, Düzgün ŞA, Coşkun A. Incidence and Aetiological Factors in Pilonidal Sinus Among Turkish Soldiers. Eur J Surg. 1999;165:339–42.
    3. Füzün M, Bakir H, Soylu M, Tansug T, Kaymak E, Harmancioglu Ö. Which technique for treatment of pilonidal sinus—Open or closed? Dis Colon Rectum. 1994;37:1148–50.
    4. Dağlar G, Yüksek NY, Gözalan U, Murat A, Kama NA. Comparison of Primary Closure and Rhomboid Flap Transposition Techniques in the Treatment of Pilonidal Sinus Disease. Turk J Surg. 2004;20:127–31.
    5. Kayaoğlu HA, Özkan N, Ersoy ÖF, Çelik A. The effect of hydrogel use on wound healing in pilonidal sinus patients undergoing surgical therapy by lay open technique. Turk J Surg. 2006;1:26–9.
    6. Dogru O, Camci C, Aygen E, Girgin M, Topuz Ö. Pilonidal Sinus Treated With Crystallized Phenol: Dis Colon Rectum. 2004;47:1934–8.
    7. Kayaalp C, Ertugrul I, Tolan K, Sumer F. Fibrin sealant use in pilonidal sinus: Systematic review. World J Gastrointest Surg. 2016;8:266.
    8. Yuksel ME. Comparision of American, German and Italian guidelines for the treatment of pilonidal disease with phenol. Tech Coloproctology. 2020;24:91–2.
    9. Kayaalp C, Tolan K. Crystallized or Liquid Phenol Application in Pilonidal Sinus Treatment. Indian J Surg. 2015;77:562–3.
    10. Kanat BH, Yazar FM, Kutluer N, Solmaz ÖA, Bozan MB, Çay F, et al. Use of silver nitrate application as mini-invasive treatment of pilonidal sinus disease. Chir [Internet]. 2021 [cited 2022 Dec 10];115(6):775–82.
    11. Kocamaz AH. Pilonidal sinüs hastalığının tedavisinde kristalize fenol ve gümüş nitrat uygulamasının karşılaştırılması. 2021 [cited 2022 Dec 10].
    12. Girgin M, Kanat BH. The Results of a One-Time Crystallized Phenol Application for Pilonidal Sinus Disease. Indian J Surg [Internet]. 2014 Feb 1 [cited 2022 Dec 10];76(1):17.
    13. Emiroǧlu M, Karaali C, Esin H, Akpinar G, Aydin C. Treatment of pilonidal disease by phenol application. Turkish J Surg [Internet]. 2017 [cited 2022 Dec 10];33(1):5.1.
    14. Kalaiselvan R, Bathla S, Allen W, Liyanage A, Rajaganeshan R. Minimally invasive techniques in the management of pilonidal disease. Int J Colorectal Dis [Internet]. 2019 Apr 1 [cited 2022 Dec 10];34(4):561–8.
    15. Sözen S, Kanat BH, Kanat Z, Namık IB, Üniversitesi K. Effective conservative treatment of umbilical pilonidal sinus disease: Silver nitrate? Salt? Breast View project Grynfelt Hernia Presenting with Left Side Pain: An Unusual Case View project. [cited 2022 Dec 10].
    16. Pappas AF, Christodoulou DK. A new minimally invasive treatment of pilonidal sinus disease with the use of a diode laser: a prospective large series of patients. Color Dis [Internet]. 2018 Aug 1 [cited 2022 Dec 10];20(8):O207–14.
    17. Mayo H. Observations on injuries and diseases of the rectum. Burgess Hill. 1833.
    18. Metzger GA, Apfeld JC, Nishimura L, Beyene TJ, Lutz C, Deans KJ, et al. Room for Improvement: The Trephination Procedure for Pediatric Patients with Pilonidal Disease. J Surg Res. 2021 Nov 1;267:605–11.
    19. Piskin T, Olmez A, Mecit EA, Unal B, Aydin C, Kayaalp C. Orifice Location Guided Excision and Flap Procedures for Treatment of Sacrococcygeal Pilonidal Disease. Adv Clin Exp Med [Internet]. 2011 [cited 2022 Dec 10];20(4):481–8.
    20. Topuz Ö, Sözen S, Tükenmez M, Topuz S, Vurdem ÜE. Crystallized Phenol Treatment of Pilonidal Disease Improves Quality of Life. Indian J Surg [Internet]. 2014 Feb 1 [cited 2022 Dec 10];76(1):81.
    21. Kayaalp C, Olmez A, Aydin C, Piskin T, Kahraman L. Investigation of a one-time phenol application for pilonidal disease. Med Princ Pract [Internet]. 2010 Mar [cited 2022 Dec 10];19(3):212–5.
    22. Olmez A, Kayaalp C, Aydin C. Treatment of pilonidal disease by combination of pit excision and phenol application. Tech Coloproctol [Internet]. 2013 Apr 1 [cited 2023 Jan 8];17(2):201–6.
    23. Velotti N, Manigrasso M, Di Lauro K, Araimo E, Calculli F, Vertaldi S, et al. Minimally invasive pilonidal sinus treatment: A narrative review. Open Med [Internet]. 2019 Jan 1 [cited 2022 Dec 10];14(1):532–6.
    24. Girgin M, Kanat BH, Ayten R, Cetinkaya Z, Kanat Z, Bozdaǧ A, et al. Minimally Invasive Treatment of Pilonidal Disease: Crystallized Phenol and Laser Depilation. Int Surg [Internet]. 2012 Dec 1 [cited 2022 Dec 10];97(4):288–92.
    25. Kurt F. Efficacy of silverdin nitrate in patients with umbilical pilonidal sinus: a retrospective clinical study. Esperienze Dermatologiche [Internet]. 2021 Jul 13 [cited 2022 Dec 26];21(2–4).
    26. Emiroǧlu M, Karaali C, Esin H, Akpinar G, Aydin C. Treatment of pilonidal disease by phenol application. Turkish J Surg [Internet]. 2017 [cited 2022 Dec 10];33(1):5.1.

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