Health Worlds

Pilonidal cyst should be treated?
Acute abscess formation, the treatment is very simple, that is, cross incision and drainage under local anesthesia, incisions or tenderness in a volatile election the most obvious place, away from the midline, not a substitute for antibiotics, surgical drainage of abscesses associated with cellulitis, or patients with diabetes, vascular heart disease or immune deficiencies, etc., can be added with antibiotics, surgery is often check wound healing, shave the hair around, gently probe with a probe sinuses, or is likely to put a bunch of Mullah out that as a foreign body hair leaving the cluster infection forever, with the above treatment, some patients may be a healing wound, but most of them in 1 to 2 months later still not healed, was chronic recurrent, thus the need for pilonidal sinus radical surgery.
Chronic pilonidal sinus radical surgery, there is no way to confirm is completely successful in the past had used surgery to treat a wide range proven to slow wound healing, in which patients suffer unnecessary pain and loss, the current use more conservative surgery, only resection of diseased tissue and to preserve normal skin and subcutaneous tissue, the preferred method is to form bags of surgery, which removed part of the sinus wall and covers the surface of the skin, suture sinus cavity and skin residual margin This can reduce the wound to promote healing, were cut on the collateral needed to end fistula, the same type of bags,


usually with gut or synthetic absorbable sutures, careful postoperative management are important, often open healing pilonidal sinus of the key, with a fine gauze dressing, packing in the sinus, and must make separate wound edges, the more the better to maintain smooth, replace the tape with a tape fixed dressings to reduce skin irritation, pay attention to local hygiene, wound aircraft found bridge, immediately separated with a cotton swab, such as excessive hair around, always shaving, excessive growth of granulation curettage or silver nitrate may be burning, regular follow-up until the wound completely healed, sometimes prolonged unhealed wound, can be often scratch, wash with water to keep clean with a pressure bandage some cases, it may promote wound healing.
Of recurrent pilonidal sinus, without extensive resection, can be similar to the original bag-shaped surgical procedure, simple and equally effective.

Pilonidal sinus and pilonidal cyst (Pilonidal sinus and Pilonidal cyst) collectively referred to as pilonidal disease (Pilonidal disese), is a cleft between the buttocks in the sacrococcygeal soft tissue of a chronic sinus or cyst, containing hair of its features. Can also be manifested as acute sacrococcygeal abscess formation after chronic sinus puncture, or temporary healing, but also wear out eventually, and so can be recurrent. Cyst with granulation tissue and fibrosis, often with a tuft. Although the disease can be seen after birth, but more in the 20 to 30 years after puberty occurs due to increased activity in sebaceous glands of hair, before the onset of symptoms. Real cause of unknown etiology, there are two theories. Medullary tube as a residual or congenital sacrococcygeal malformations lead to skin sewn bear with things. But after the baby's middle bit shallow concave parts anal pilonidal disease rarely found in precursor lesions, and indeed more common in adults. Second, that the sinus and cyst acquired is due to injury, surgery, foreign body irritation and chronic granulomatous disease caused by infection. Recently confirmed by the hair outside the times of entry is the main cause. Hip fracture between the negative attraction, hair loss can penetrate the skin. Split hairs over the long, wool filtration and dip the top of the role of fur skin, hair and penetrate the skin, the formation of short-track, after deeper into the sinus to the sinus hair root loss can also penetrate the hair shaft, in the pathogenesis changes seen during exercise (Figure 2), but only half of the cases can be found in the hair, the disease is more common in multi-level hair, sebum over-activity, too deep cleft between the buttocks and hips often injured patients. Sacrococcygeal regular driver of the car by the long-term skin Britain waves, damage, sebaceous gland tissue and debris can deposit accumulation in the capsule, causing inflammation. The disease occurs more U.S. Army, known as the Jeep disease. Common bacteria are anaerobic bacteria, staphylococcus, streptococcus and E. coli. Rainsbury and Southan analysis of the still pilonidal disease, fewer than half of single bacteria, and anaerobes account for 58%. The strange thing is less common Staphylococcus aureus, the majority of aerobic gram-negative bacteria. Pilonidal cyst without secondary infection often asymptomatic, but sacral processes, and some sense of sacral pain and swelling. The first symptom is usually the primary and acute abscess in the sacrococcygeal, local red, swollen, hot, pain and other characteristics of acute inflammation. Automatically break out of more than surgical drainage of pus or inflammation subsided after a few drainage port can be completely closed, but most often manifested as recurrent or water to form sinus or fistula. Quiescent pilonidal sinus can be seen in the sacrococcygeal midline skin irregular holes at a diameter of about 1mm ~ 1cm. Skin irritation around the hard, often scars, some visible hair. Probed to probe into 3 ~ 4mm, and some can probe into the 10cm, squeezed light can be emitted foul thin liquid. Acute exacerbation of acute inflammation, tenderness and swelling, discharge more purulent discharge, abscess and cellulitis sometimes occur. Surgical treatment of pilonidal sinus surgery is the main method of treatment, but inflammation is taboo and should subside once the inflammation after surgery. Surgical methods are the following: 1. Resection of a suture removal of all diseased tissue, muscle and skin free, fully stitched the wound, so that a healing. To eliminate the deep cleft between the buttocks and the negative pressure, reduce wound dehiscence, hematoma and abscess, Z form a viable technique (Figure 1). Apply online for a small cyst and no infection in the sinus, the recurrence rate of 0% ~ 37%, the advantage of the healing time is short, split between hip scar formation within the soft activities in the scar and soft tissue between the sacrum, can be tolerated injury. 2. Resection of part of the suture removal of the lesion, and wound closure on both sides of the skin and the sacral fascia, so that most of the wound healing, granulation tissue from the middle part of the healing of wounds. Applicable to many cases of sinus ostium and the effect removal of a suture with the same, but the healing time longer. 3. Resection suture of the wound opening times for serious infections and a suture incision wound infection cases. 4. Resection of open wounds can not be too big for the wound closure and surgical recurrence of the disease. Simple operation, but the healing of a long, extensive scar formation, and only a thin layer of epithelium, stick in the sacrum, if damaged, scar easily broken. 5. Marsupialization partial removal of the sinus wall and covers the surface of the skin, with gut or synthetic absorbable sutures to promote wound healing. Careful postoperative care, can often see satisfactory results. Used for unresectable or recurrent cases of pilonidal sinus. Pilonidal sinus of the sacrococcygeal nest of non-surgical treatments do not need treatment, because only in the sacrococcygeal joint, sacrum and coccyx tip of the lower part of a depression, without any symptoms, no clinical significance. Sacrococcygeal sacrococcygeal pilonidal sinus and swelling, such as infection, anti-inflammatory treatment should be held to keep local cleaning, such as the reproduction of abscess, incision and drainage should be. However, thicker skin and subcutaneous tissue sacrococcygeal hard, no evident early, inflammation often spto surrounding tissue caused by cellular inflammation. Deep tissue necrosis, should be early incision and drainage. Sclerotherapy is the injection of corrosion to the sinus medicines, sinus and cyst epithelial damage, the cavity and the sinus closed. Since 1960, injection therapy was applied phenol solution, but not many applications because the application is pure phenol solution, severe pain, after the switch to 80% concentration, and under general anesthesia; sinus into the jelly to protect the the surrounding skin. Hegge (1987) with 80% phenol solution, 1 ~ 5ml slowly injected into the sinus, about 15min, slow injection to prevent complications such as skin burns, fat necrosis or severe pain. This method can be repeated every 4 to 6 weeks 1, about half of the patients can be cured after only one injection, 12% needed injection of 5 times or more. 43 cases were followed up for years, only 3 patients (6%) recurred. Stansby (1989) under general anesthesia, 80% of the sinus into the phenol solution, retentimin, sinus curettage, repeated 3 times, treated 104 cases of sterile abscess occurred in 4 cases, 1 case of cellulitis bee disease, no Other complications. 65 patients with surgical resection of comparison, treatment; resection was 86%, 75% phenol injection; followed up an average of 8 months (3 months to 4 years), resection in 10 patients with recurrent injection of 12 cases of recurrence. Clinical manifestations Pilonidal cyst without secondary infection often asymptomatic, but sacral processes, and some sense of sacral pain and swelling. The first symptom is usually the primary and acute abscess in the sacrococcygeal, local red, swollen, hot, pain and other characteristics of acute inflammation. Automatically break out of more than surgical drainage of pus or inflammation subsided after a few drainage port can be completely closed, but most often manifested as recurrent or water to form sinus or fistula. Quiescent pilonidal sinus can be seen in the sacrococcygeal midline skin irregular holes at a diameter of about 1mm ~ 1cm. Skin irritation around the hard, often scars, some visible hair. Probed to probe into 3 ~ 4mm, and some can probe into the 10cm, squeezed light can be emitted foul thin liquid. Acute exacerbation of acute inflammation, tenderness and swelling, discharge more purulent discharge, abscess and cellulitis sometimes occur. Should boil the differential diagnosis of anal fistulas and granulomas identified. Growth in the skin boils, highlighted by the skin, the top yellow. Carbuncle multiple external orifice, the necrotic tissue. From outside the mouth of anal fistula *** close to the fistula line *** palpation have cords, within the anal canal inside the mouth, there is pus in the history *** rectum. The Traveling pilonidal sinus directions, and more to the cranial side, very little down. Tuberculous granuloma and the bone is connected, X-ray shows bone are destroyed, other parts of the body lesions of tuberculosis. Syphilitic granuloma has a history of syphilis, syphilis seropositive. Outcomes pilonidal sinus cancer occurred in rare, Phipshen (1981) reof the literature only 32 cases. Lesions are mostly well-differentiated squamous cell carcinoma. Wounds caused by suspected cancer should be changed, such as ulcers and break, growing fast, and fungal-like edge of the car. Wide excision should be preferred. As the wound with a skin graft or flap widely used treatment. Inguinal lymph nodes biopsy should be made to exclude any transfer, if transfer of the poor prognosis reported in the literature 5-year survival was 51%. 50% recurrence rate points. Found in newly diagnosed inguinal lymph node metastasis 14%.


Friends Links:Automation Control Blog
Automation Products Order Numbers