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Fibrin glue is a quick and effective treatment for primary and recurrent pilonidal sinus disease
T S Sian1,2, P J J Herrod3,4, J E M Blackwell3,4
1Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK. t.sian@nhs.net.
Insights
Fibrin glue obliteration is an effective treatment for pilonidal sinus disease (PSD), offering a quick procedure with high healing rates after two rounds of treatment. This minimally invasive approach provides a viable alternative to traditional radical surgeries for PSD.
Area of Science:
- Surgical Innovation
- Minimally Invasive Procedures
- Wound Healing
Background:
- Pilonidal sinus disease (PSD) is a chronic inflammatory condition impacting young males, causing significant health and economic burdens.
- Traditional surgical interventions for PSD often lead to complications such as pain, prolonged recovery, and poor cosmetic outcomes.
Purpose of the Study:
- To evaluate the efficacy of fibrin glue as a primary treatment for pilonidal sinus disease (PSD).
Main Methods:
- Retrospective analysis of 146 patients undergoing curettage and fibrin glue obliteration for PSD between January 2011 and January 2016.
- Data collection included operative details, recurrence rates, and time to recurrence.
Main Results:
- 99% of patients were discharged same-day, with a median operative time of 9 minutes.
- A 27% recurrence rate was observed after one fibrin glue application, with 60% of these successfully retreated.
- A high healing rate of 96.9% was achieved after two rounds of fibrin glue treatment.
Conclusions:
- Fibrin glue application after sinus curettage is a rapid and effective treatment for pilonidal sinus disease (PSD).
- This minimally invasive technique serves as a successful first and second-line therapeutic option for PSD, improving patient outcomes.
Background:
Pilonidal sinus disease (PSD) is a common, chronic inflammatory condition involving hair follicles within the natal cleft. It mainly affects young males and creates a significant health, social and economic burden. Traditional surgery is often radical resulting in pain, wound complications, long recovery times and poor cosmesis. The aim of our study was to evaluate fibrin glue as a primary treatment for PSD.
Methods:
Fibrin glue procedures for a single surgeon at our institution were identified from operative coding databases and the logbook from January 2011 to January 2016. Patients had curettage of the sinus with fibrin glue obliteration. Recurrence data was collected retrospectively.
Results:
One hundred and forty-six patients were identified; (115 (79%) males, mean age 30 (range 16-78 years). One hundred and forty-four (99%) were discharged the same day. Four (2.7%) were treated conservatively for wound discharge. Median operating time was 9 (range 4-28) min. There were 40 (27%) recurrences after one glue application. Median time to recurrence was 4 (range 0.25-36) months. Twenty-four (60%) of the recurrences had repeat glue treatment with 4 (16.6%) recurrences. After 2 rounds of treatment with glue alone, 126 out of 130 (96.9%) patients had healed.
Conclusions:
Fibrin glue application following curettage of the sinus is a quick and effective procedure for first and second line treatment of PSD.
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