povidone-iodine and Pilonidal-Sinus

There are different opinions about the treatment of umbilical pilonidal sinus. The aim of the present study was to evaluate the outcome of conservative treatment of this disease.. All patients with umbilical pilonidal sinus who attended our private surgical clinic in Erbil, Kurdistan, from January 1997 to August 2011, were treated by conservative treatment. Umbilectomy was performed for those who did not respond to the conservative treatment after three sessions.. A total of 134 patients were seen; 121 (90.3 %) were men. Only 105 (78.35 %) patients came back for the second visit. Eighty of them (76.19 %) responded to the treatment. The other 25 (23.8 %) patients were retreated by a second session of conservative treatment. Of these 25 patients, 19 (76 %) came back for the third visit and only three (15.78 %) patients did not respond to the treatment. One patient insisted on umbilectomy. The other two patients were treated but did not respond to the third session treatment. Umbilectomy was performed for them. Hair was found in the sinus after excision in these three patients. The follow-up period ranged from 9 months to 6.5 years for 46 (34.32 %) patients and revealed no recurrence.. Conservative treatment should be regarded as the first choice and the main method of treatment in the management of umbilical pilonidal sinus. Improper extraction of hair is the main cause of failure of conservative treatment. Recurrence can be prevented by giving the patients instructions on preventive measures.

Topics: Adolescent; Adult; Amoxicillin; Anti-Infective Agents; Combined Modality Therapy; Drainage; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Metronidazole; Pilonidal Sinus; Povidone-Iodine; Recurrence; Skin Care; Treatment Outcome; Umbilicus; Young Adult

Primary closure after excision of postanal pilonidal sinus disease frequently has been complicated by wound break-downs. Healing by second intention takes many weeks and requires supervised wound care. A simple technique has been developed which has resulted in primary healing in 28 of 31 patients treated in a 5-year period. Sepsis and haematoma formation, the causes of wound breakdown after pilonidal sinus excision, have been prevented by preoperative preparation, prophylactic antibiotic administration, wound irrigation with povidone-iodine and simple skin closure over a Redivac suction drain for at least 4 days. This series suggests that primary closure can be successful using the technique described.

Topics: Adolescent; Adult; Cephalothin; Female; Hemostasis, Surgical; Humans; Male; Pilonidal Sinus; Postoperative Care; Postoperative Complications; Povidone-Iodine; Preoperative Care; Suction; Suture Techniques