Predisposing factors for failure of conservative treatment in umbilical pilonidal sinus: A clinical experience

Aim: Pilonidal sinus is a chronic inflammatory disease that occurs in the sacrococcygeal region; but also occurs in theumbilical region. Conservative and surgical treatment methods have been used for management of umbilical pilonidalsinus. Aim of this study was to evaluate the risk factors for failure of conservative treatment.Materials and Methods: Between June 2016 and March 2018, 16 patients diagnosed with umbilical pilonidal sinus in ourclinic were evaluated retrospectively. The demographical and clinical data, interventions, complications and follow-upresults of the patients were recorded.Results:All of 16 patients initially treated conservatively. After conservative treatment, pilonidal sinus excision wasperformed to 7 (43.75%) patients; five (31.25%) of that patients had no regression of symptoms and two (12.5%) of themhad recurrence. Personal history of umbilical pilonidal sinus, dark skin color, deep navel, and poor personal hygiene werefound as predisposing factors for failure of conservative treatment.Conclusion: Although there is no consensus in the treatment of umbilical pilonidal sinus; the first treatment approachshould be conservative. It should be kept in mind response to conservative management could be poor in patients withthe predisposing factors.

PDF

___

1. Hodges RM. Pilonidal sinus. Boston Med Surg 1880;103:485- 6.
2. Patey D, Williams ES. Pilonidal sinus of the umbilicus. Lancet 1956;271:281-2.
3. Eryılmaz R, Sahin M, Okan I, et al. Umbilical pilonidal sinüs disease: predisposing factors and treatment. World J Surg 2005;29:1158-60.
4. Tocchi A, Liotta G, Agostini N. The umbilical pilonidal cyst: A case report-comments on its pathogenesis and treatment. G Chir 1994;15:33-6.
5. Dixit SP. Pilonidal sinus of umbilicus. Can J Surg 1976;19:422-6.
6. Kareem T. Outcomes of conservative treatment of 134 cases of umbilical pilonidal sinus. World J Surg 2013;37:313-7.
7. Fazeli MS, Lebaschi AH, Adel MG, et al. Evaluation of the outcomes of complete sinus excision with reconstruction of the umbilicus in patients with umbilical pilonidal sinus. World J Surg 2008;32:2305-8.
8. Gupta S, Sikora S, Singh M, et al. Pilonidal disease of the umbilicus- a report of two cases. Jpn J Surg 1990;20:590-2.
9. Heller DS. Lesions of the umbilicus: what the minimally invasive gynecologic surgeon needs to know about the belly button. J Minim Invasive Gynecol 2012;19:680-3.
10. Kaplan M, Ozcan O, Kaplan FC, et al. Conservative vs. surgical interventions for umbilical pilonidal sinus:A multicenter, double-blind, prospective, randomized clinical trial. J Am Coll Surg 2016;222:878-89
11. Patey DH. A reappraisal of the acquired theory of sacrococcygeal pilonidal sinus and assesment of its influence on surgical practice. Br J Surg 1969;56:463-6.
12. Bascom J. Long term results of follicle removal. Dis Colon Rectum 1983;26:800-7.
13. Karidakis GE. Easy and successfull treatment of pilonidal sinus after explanation of its causative process. Aust NZJ Surg 1992;62:385-9.
14. Sarmast MH, Javaherizadeh H, Shahvari MR. Non-surgical treatment of umblical pilonidal sinus in adolescent and adult cases. Pol Przegl Chir 2011;83:652-3.
15. Al-KadiAS. Umbilical Pilonidal Sinus. International Journal of Health Sciences 2014;8:308-10.
16. McClenathan JH. Umbilical pilonidal sinus. Can J Surg 2000;43:225.