The common name of this disease, which doctors call "Pilonidal sinus" among the public, is "Ingrown Hair".
A cavity (cavity) under the skin in the coccyx area. It is a disease that occurs with the development of There is often hair in the cavity or cyst, and as a result of inflammation of this cavity, chronic infection under the skin in the coccyx area and one or more holes in the skin occur. It is thought to occur when midline hair follicles become blocked by skin secretions or hair. The disease is more common in men than in women, and occurs more frequently between adolescence and the age of 40.
WHAT ARE THE FACTORS THAT MAKE THE DISEASE EASIER?
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Excessive body hair
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The fact that the skin remains moist for a long time makes it easier for the hair to ingrown
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A scar or crack in the cleft between the buttocks
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Hair accumulating in this area due to sitting for a long time constantly causes injury in this area
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Poor hygiene
However, sometimes the disease can be seen without any facilitating factors…
WHAT ARE THE SYMPTOMS OF THE DISEASE?
In most patients, an acute abscess process occurs. A "clinical picture" occurs in the form of severe pain, swelling, redness, high fever and weakness in the coccyx. As a result, it often ends with purulent (yellow-green) discharge from the coccyx. After the abscess disappears, a "pilonidal sinus" occurs spontaneously or after medical intervention. Chronic disease manifests itself with swelling, pain and discharge in the coccyx. Surgical treatment is often required.
WHAT IS THE TREATMENT OF THE DISEASE?
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In the presence of acute abscess in outpatient clinic or operating room conditions. An incision should be made in the abscess and the purulent material inside should be drained. After the procedure, it is recommended to keep this area clean and treat it with antibiotics.
- Among the surgical methods, many alternative interventions have been described, perhaps the most It is one of the diseases for which many surgical methods have been described. The main ones are: ır;
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Cystotomy is the cleaning of the cavity by opening the ceiling of the cavity formed by hairs and inflammatory material. The resulting cavity is cleaned, It is expected to fill spontaneously by dressing frequently. Antibiotics may need to be given, the average recovery period is 2-5 weeks. The risk of recurrence is between 7-15%.
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Marsupialization,The ceiling of the space formed by hairs and inflammatory material is opened and the inside is cleaned, the base of the cyst is left and the edges of the cyst are stitched to the base of the cyst. . Thus, the remaining space is reduced. By frequent dressing and removal of dead tissue and hair from the wound, the gap is filled with tissue that will grow from underneath. The healing process is 4-6 weeks and the risk of recurrence is 1-5%.
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The gap created by hair and inflammatory material removing and leaving the wound open; With an elliptical incision made to include the space formed by the hair and inflammatory material and the adjacent sinuses, if any, the extent of the cyst is removed up to the sacral bone (coccyx) fascia. The wound is left open and the wound space is expected to be filled with the tissue growing from the bottom by frequent dressing. Healing time is 6-7 weeks and the risk of recurrence is between 1-7%.
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Removing the gap created by the hair and inflammatory material and closing the wound; The space created by the hair and inflammatory material is removed, a closed absorbent drain is placed in the wound place and the wound lips are joined together. The healing process is 2-3 weeks, but the risk of recurrence varies between 6-20%.
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Removal of the gap created by the hair and inflammatory material and wound healing. Closing with a neighboring tissue brought to that area: In the "Flap method", the remaining space is closed with patches created from surrounding tissues. There are different types of patch methods, which type of patch to apply depends on the location of the sinus, the degree of inflammation and the shape of the remaining space. decision is made. The risk of recurrence is 0-5%. In our country, “Limberg” type flaps are most commonly used.
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A method that may be seen as a non-surgical method, but has been used increasingly by surgeons recently, is crystallized “Phenol into the pilonidal sinus following cleaning. ” It is the placement of parts, thus creating fibrotic tissue and providing treatment.
Apart from these, many surgical methods have also been described. However, the "risk of recurrence" is on the agenda in almost all methods. Good results are directly proportional to the availability of surgeons who have knowledge and experience on the subject.
WHAT SHOULD BE DONE TO PREVENT THE DISEASE FROM RETURNING?
The wound area is clean after the surgery. should be kept and contact with foreign objects should be prevented. During this period or beyond, the skin of the hips should be kept clean and hairless. This should be achieved by shaving every 2 weeks or using hair removal creams until the age of 30-35. As age progresses, the hair becomes weaker and thinner and the depth between the buttocks decreases, thus reducing the risk of recurrence.
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