Effects of methylene-blue staining on the extent of pilonidal sinus excision
M Ardelt1, R Kocijan2, Y Dittmar1
1University of Jena, Department of General, Visceral and Vascular Surgery, Erlanger Allee 101, 07747 Jena, Germany.
Objective:
We aimed to examine the effects of methylene-blue staining (MBS) on the volume of specimens after excision of pilonidal sinuses.
Method:
This was a retrospective analysis of 135 excised specimens after pilonidal sinus (PS) surgery. All patients underwent procedures at the Department of Surgery of University Hospital Jena between 2000 and 2010. All specimens were measured in three dimensions. To calculate the volumes of excised specimens, we used a model of a hemi-ellipsoid. Demographic information (age, height, weight, body mass index, smoking status) were also obtained for all patients.
Results:
Excised specimens with MBS had significantly larger volumes (p<0.001) as reflected in length (p=0.001), width (p=0.001), and depth (p=0.017) of the excised specimen compared with specimens that were not stained with methylene blue (MB). In addition, the volume was larger in subjects with a recurrent PS (p=0.021), which was predominantly the case in female subjects (p=0.025).
Conclusion:
These data suggest that excised specimens with MBS had significantly larger volumes of the excised specimen compared with specimens that were not stained with MB. MBS of a fistula system could enable such a system to be marked sufficiently, thereby facilitating complete resection of a PS.
Insights
Methylene-blue staining (MBS) significantly increases the measured volume of excised pilonidal sinus (PS) specimens. This technique may improve complete surgical resection of PS by enhancing visualization of the fistula system.
Area of Science:
- Surgical Pathology
- Medical Imaging
- Clinical Research
Background:
- Pilonidal sinus (PS) disease is a common condition requiring surgical excision.
- Accurate assessment of excised specimen volume is crucial for evaluating surgical outcomes.
- Methylene-blue staining (MBS) is used to visualize complex anatomical structures.
Purpose of the Study:
- To investigate the impact of methylene-blue staining (MBS) on the volumetric measurements of pilonidal sinus (PS) excision specimens.
- To determine if MBS affects the perceived size of resected PS tissue.
Main Methods:
- Retrospective analysis of 135 pilonidal sinus (PS) excision specimens.
- Specimens were measured in three dimensions, with volume calculated using a hemi-ellipsoid model.
- Demographic data including BMI and smoking status were collected.
Main Results:
- Excised specimens stained with methylene-blue (MB) exhibited significantly larger volumes compared to unstained specimens (p<0.001).
- MBS correlated with increased length (p=0.001), width (p=0.001), and depth (p=0.017) of specimens.
- Larger specimen volumes were observed in recurrent PS cases, particularly in female patients (p=0.021).
Conclusions:
- Methylene-blue staining (MBS) leads to a significant increase in the measured volume of pilonidal sinus (PS) excision specimens.
- MBS may enhance the visualization and marking of the fistula system, potentially aiding in complete PS resection.
- This finding suggests MBS could be a valuable adjunct in PS surgery to ensure thorough tissue removal.
