Bacterial colonization in uninfected pilonidal cyst and its role in developing recurrence in postoperative period: Prospective study

Bacterial colonization in uninfected pilonidal cyst and its role in developing recurrence in postoperative period: Prospective study

Aim: To determine the bacterial prevalence and its susceptibility to antibiotics, and additionally, to investigate the relationshipbetween bacterial status and recurrence and complications with regard to whether bacteria reproduce in the cyst cavity in uninfectedpilonidal cyst.Material and Methods: The cases included in the study were those who applied to our clinic due to pilonidal sinus and surgicaloperation was decided. Before the operation, culture specimen was taken using a sterile swab stick from the cyst hole. The cyst wasexcised with a safety margin. The excised material was opened under the guidance of the cyst hole and the cavity was entered andsamples of cyst tissue and content were collected for culture-antibiogram.Results: Totally 46 cases were included in our study, Average age was 26 (18-47) years. Limberg flap was performed to 37 (78%)of the cases, and primary repair to 9 (22%) cases. Average follow-up period was 27.1 (sd±7.6) months. Normal bacterial skin florawas determined in 6 (13%) cases and significant bacterial reproduction in 4 (8.6%) cases (Enterococcus faecalis, Streptococcusanginosus, MRSA, Streptococcus dysgalactiae ) in the cyst cavity culture. In tissue culture however, skin bacterial flora was observedin 9 (19.5%) cases, while bacterial growth only in 1 case. Recurrence was determined in 3 (3.6%) cases in total. Bacterial growth, andother factors were not associated with recurrence (p> 0.05)Conclusion: In this study, non-infected pilonidal sinus surgery does not require bacterial culture to prevent recurrence.

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  • 1. Ardelt M, Dittmar Y, Kocijan R, et al. Microbiology of the infected recurrent sacrococcygeal pilonidal sinus. Int wound J 2016;13:231-7.
  • 2. Minneci PC, Halleran DR, Lawrence AE, et al. Laser hair depilation for the prevention of disease recurrence in adolescents and young adults with pilonidal disease: study protocol for a randomized controlled trial. Trials 2018;19:599.
  • 3. Da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum 2000;43:1146-56.
  • 4. Hull TL, Wu J. Pilonidal disease. Surg Clin North Am 2002;82:1169-85.
  • 5. Johnson EK, Vogel JD, Cowan ML, et al. The American society of colon and rectal surgeons’ clinical practice guidelines for the management of pilonidal disease. Dis Colon & Rectum 2019;62:146-57.
  • 6. Iesalnieks I, Ommer A. The management of pilonidal sinus. Dtsc Ärztebl Int 2019;116:12-21.
  • 7. Stauffer VK, Luedi MM, Kauf P, Schmid M, et al. Common surgical procedures in pilonidal sinus disease: A metaanalysis, merged data analysis, and comprehensive study on recurrence. Sci Rep 2018;8:3058.
  • 8. Søndenaa K, Nesvik I, Andersen E, et al. Bacteriology and complications of chronic pilonidal sinus treated with excision and primary suture. Int J Colorectal Dis 1995;10:161-6.
  • 9. Garg P, Menon GR, Gupta V. Laying open (deroofing) and curettage of sinus as treatment of pilonidal disease: a systematic review and meta-analysis. ANZ J Surg 2016;86:27-33.
  • 10. Enriquez-Navascues MJ, Emparanza JI, Alkorta M, et al. Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus. Tech Coloproct 2014;18:863-72.
  • 11. Horwood J, Hanratty D, Chandran P, et al. Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease. A meta-analysis of randomized controlled trials. Colorectal Dis 2012;14:143- 51.
  • 12. Mostafaei S, Norooznezhad F, Mohammadi S, Norooznezhad AH. Effectiveness of platelet-rich plasma therapy in wound healing of pilonidal sinus surgery: a comprehensive systematic review and meta-analysis. Wound Rep Regen 2017;25:1002-7.
  • 13. Biter LU, Beck GM, Mannaerts GH, et al. The use of negativepressure wound therapy in pilonidal sinus disease: a randomized controlled trial comparing negative-pressure wound therapy versus standard open wound care after surgical excision. Dis Colon Rectum 2014;57(12):1406-11.
  • 14. Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Tech Coloproctol 2009;13:189-93.
  • 15. Harries RL, Al-Qallaf A, Torkington J, et al. Management of sacrococcygeal pilonidal sinus disease. Int wound J 2019;16:370-78.
  • 16. Mavros MN, Mitsikostas PK, Alexiou VG, et al. Antimicrobials as an adjunct to pilonidal disease surgery: a systematic review of the literature. Eur J Clin Microbiol & Infec Dis 2013;32:851-8.
  • 17. Søndenaa K, Diab R, Nesvik I, et al. Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. Combined prospective study and randomised controlled trial. Eur J Surg 2002;168:614-8.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi