Mehmet Eren YÜKSEL

Crystallized phenol treatment is less effective in patients with recurrent pilonidal disease after surgery compared to patients with primary pilonidal disease

Aim: Primary pilonidal disease can be treated with crystallized phenol with an overall cure rate of 80%. However, the effect ofcrystallized phenol in patients who had recurrence after pilonidal disease surgery has not been analyzed in the English medicalliterature in detail yet. The purpose of this study was to investigate the effect of crystallized phenol in recurrent pilonidal disease.Material and Methods: 28 male and 10 female patients who had recurrence after surgical intervention to treat pilonidal diseasewere evaluated. Twenty male and 8 female patients underwent excision and primary closure surgery, whereas 8 male patientsand 2 female patients underwent modified Limberg flap surgery. All of these 38 patients were treated with one-time application ofcrystallized phenol.Results: The mean period for recurrence of patients treated with single application of crystallized phenol after primary excision andprimary closure surgery was 45.85±11.82 days (range: 35-90 days) and it was 66.5±25.31 days (range: 40-120 days) after modifiedLimberg flap surgery. The follow-up period was 6 months. The cure rate in recurrent excision and primary closure group was 57.14%,whereas the cure rate in the recurrent modified Limberg flap group was 40%. Overall cure rate was 52.63%.Conclusion: As a result, crystallized phenol treatment was less effective in patients who had recurrence after pilonidal diseasesurgery in comparison to patients who were only treated with crystallized phenol without prior surgical intervention.

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1. 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.
2. Kober MM, Alapati U, Khachemoune A. Treatment options for pilonidal sinus. Cutis 2018;102:23-9.
3. Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Tech Coloproctol 2009;13:189-93.
4. Emiroglu M, Karaali C, Esin H, et al. Treatment of pilonidal disease by phenol application. Turk J Surg 2017;33:5-9.
5. Yuksel ME. Pilonidal sinus disease can be treated with crystallized phenol using a simple three-step technique. Acta Dermatovenerol Alp Pannonica Adriat 2017;26:15-7.
6. Halleran DR, Lopez JJ, Lawrence AE, et al. Recurrence of pilonidal disease: our best is not good enough. J Surg Res 2018;232:430-6.
7. Bascom J, Bascom T. Failed pilonidal surgery: new paradigm and new operation leading to cures. Arch Surg 2002;137:1146-50.
8. Doll D, Krueger CM, Schrank S, et al. Timeline of recurrence after primary and secondary pilonidal sinus surgery. Dis Colon Rectum 2007;50:1928-34.
9. Aygen E, Arslan K, Dogru O, et al. Crystallized phenol in nonoperative treatment of previously operated, recurrent pilonidal disease. Dis Colon Rectum 2010;53:932-5.