Fibrin sealant use in pilonidal sinus: Systematic review

Area of Science:

• Surgical Innovation
• Wound Management
• Biomaterials in Medicine

Background:

• Pilonidal disease is a chronic condition requiring effective treatment.
• Fibrin sealant (FS) is a hemostatic agent with potential applications in wound closure and tissue regeneration.
• Current data on FS efficacy in pilonidal disease management is limited.

Purpose of the Study:

• To review current data on the success rates of fibrin sealant use in pilonidal disease treatment.
• To evaluate the effectiveness of FS in different applications within pilonidal sinus surgery.

Main Methods:

• Systematic literature search across major databases (PubMed, Google Scholar, Ebsco-Host, ClinicalTrials, Cochrane).
• Inclusion of nine studies with a total of 217 patients (84% male, mean age 24.2 ± 7.8).
• Analysis of FS use for sinus tract filling, wound coverage, and dead space obliteration.

Main Results:

• No reduction in wound complication rates when FS was used to obliterate dead space (9.8% vs 14.6%).
• Improved wound healing time (mean 17 days) and patient comfort (88% satisfaction) when FS covered laid-open areas.
• Approximately 20% recurrence rate when FS was used to fill sinus tracts.

Conclusions:

• Fibrin sealant is ineffective for decreasing seroma formation in pilonidal disease.
• Filling sinus tracts with FS is not recommended due to high recurrence and lack of superiority over other treatments.
• Further comparative studies are warranted to confirm the benefits of FS in covering laid-open surgical wounds.