Fibrin Glue in the Treatment of Pilonidal Sinus: Results of a Pilot Study

Wolfson Digestive Diseases Centre, School of Medical and Surgical Sciences, University of Nottingham, The Medical School, Derby City Hospital, Derby DE22 3DT, UK.
Diseases of the Colon & Rectum (Impact Factor: 3.75). 06/2005; 48(5):1094-6. DOI: 10.1007/s10350-004-0905-4
Source: PubMed


Pilonidal sinus is a common condition of uncertain etiology. There is no agreed best surgical treatment. Treatment of fistula-in-ano has been described with some success with fibrin tissue glue. The use of fibrin glue is investigated in this pilot study.
Six patients with chronic pilonidal sinus were treated with injection of fibrin tissue glue after curettage of the pits.
There were no complications. Postoperative discomfort was minimal and early return to normal activities was possible. There was no recurrence of disease in five of six patients at one year.
Fibrin tissue glue may be a possible novel treatment for pilonidal disease.

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Available from: Jonathan N Lund, Jun 17, 2015
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    • "They never create the massive wounds and years of misery that can follow the ill-advised, but commonly taught, wide excision. Included in approaches to consider are nonsurgical management [6], phenol injections [7], simple incision techniques, fibrin glue [8], and the surgical approach that we favor: " pick pits " and " stay out of the ditch " [1]. We find the evidence compelling that the cleft is the cause. "
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    ABSTRACT: Refractory pilonidal disease is a problem. We wished to show the utility of the cleft lift procedure in solving nonhealing. We selected a subset of challenging cases for this study. The subset included all patients referred with persistent open wounds despite at least 2 prior pilonidal surgeries elsewhere. The 69 patients had undergone 223 surgeries (average, 3) and endured open wounds for a sum of 365 years (average, 5). All patients we contacted were healed after a single cleft lift surgery with 3 exceptions. Two patients required 2 lifts before healing and 1 patient required 3 lifts. The cleft lift procedure gave excellent results in patients with refractory pilonidal disease.
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    ABSTRACT: Complete excision is the preferred treatment for pilonidal sinus disease. We describe a new technique of excision and tension-free primary closure of pilonidal sinus disease, combined with application of fibrin glue in order to obliterate the dead space and to promote wound healing. A curved incision of the carried out, 2-3 cm lateral to the opening of the sinus, done under general or spinal anesthesia, and a thick flap was created by undercutting the medial edge and advancing it across the midline. The sinus was completely excised with all of its extensions. The flap was then sutured back to its original place by several interrupted monofilament mattress sutures. Then, 2-4 ml of fibrin glue was injected through the original pilonidal sinus opening to the sinus bed in order to obliterate the dead space. Thirty patients with pilonidal sinus disease were treated by this technique. In four patients, there was a temporary purulent discharge through the opening of the sinus, and there were no other complications. The mean period for returning to daily activities and to work for patients was 11 days (SD=6 days). No infection or recurrent disease was noticed during the follow-up period (23+/-3 months). Complete excision with tension free closure with fibrin glue application may be a useful technique for the treatment of pilonidal sinus disease.
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