Umbilical Pilonidal Disease;Predisposing Factors & Best Modality of Management
Journal Title: Journal of Surgery - Year 2018, Vol 6, Issue 2
Abstract
Umbilical pilonidal sinus is an unusual variant of the pilonidal diseases. It occurs with an incidence thought to be 0.6%. Little was reported in literature about the disease. This study is a prospective one that aims at investigating factors predisposing to the development of disease and comparing different modalities of treatment. All patients for more than fourteen years, were involved &assessed for age, gender, family history, hirsute state, obesity, local hygiene, and the presence of deep umbilical cleft were reported & compared with a control group Three modalities in treatment were compared ; conservative measures only (group A), curettage and conservative measures (group B), and omphalectomy with reconstruction of new umbilicus (group C). Seventy eight cases were presented. Significant differences were present in age, sex, lack of local hygiene, & deep umbilicus compared to control group. Conservative modalities are quite efficient modality for treatment that was successful in 77% of the patients. Recurrence occurred in nine patients (23%) of group A & six patients 20% in group B. No recurrence reported in group C (19 cases) , with only one (4%) with minor complications (seroma) The cosmetic acceptance was good in seventeen patients (68%), accepted in six patients (24%) and not accepted in one patient (4%). The study concluded that; deep navel, hairiness, and poor local umbilical hygiene are necessary for the umbilical pilonidal disease to be developed. Conservative management is a well efficient modality of treatment and should be considered as an initial modality of choice. Surgical treatment should be only confined to those fail to tolerate conservative measures. We prefer to remove the umbilicus and fashioning of new umbilicus with base and cylinder rather thancone shaped to be less risky for trapping hair to avoid the recurrence & cosmetically accepted by the patient.
Authors and Affiliations
Elsaady A
Keywords
Related Articles
- EP ID EP478427
- DOI 10.13188/2332-4139.1000045
- Views 121
- Downloads 0
Interferon Treatment Improves Survival among Liver Transplant Recipients with Recurrent Hepatitis C
Hepatitis C in the liver allograft recipient has an aggressive course. A significant proportion of such recipients develop graft fibrosis and cirrhosis within five years of transplantation. Treatment efficacy with standa...
Anal Fistula Repair with Acellular Dermal Matrix Plug: Description of a Novel Technique and Early Results
Background: The interest of colorectal surgeons has shifted over the years towards the development of “sphincter-saving” surgical techniques. The aim of the present study was to evaluate the efficacy of the new device in...
Multistep Progression from Atypical Adenomatous Hyperplasia to Lung Adenocarcinoma: Clinico-Pathologic, Epigenetic and Genetic Aspects
Detection of small peripheral ground-glass opacity nodules has increased due to the advances in imaging modalities and the widespread use of computed tomography screening. Pathologic examination of these nodules revealed...
A Case-Series of Solitary Skull Neoplastic Lesions Treated with En-Block Resection and Complex Cranioplasty
Background and aims: Tumors involving the calvarium but extending into the adjacent scalp layers and/or the underlying dura and brain are technically challenging to treat. Patients often present late in the course of dis...
Early Migration of the R3 Uncemented Acetabular Component: A Prospective 2 Year Radiostereometric Analysis
Background: Radiostereometric Analysis (RSA) is a highly accurate and true three dimensional method that analyses implant micromotion following total joint replacement surgery. This methodology was used to assess the mig...