• Main
  • Useful links
  • Information for Contributors
  • About
  • Editorial board

    •
    Bulletin of problems biology and medicine / Issue 3 (166), 2022 / SURGICAL TREATMENT OF RECURRENCE OF PILONIDAL CYSTS OF THE SACROCOCCYGEAL AREA USING CROSSLINKED POLYURETHANE ADHESIVE AND IZOTRETINOIN

    Feleshtynskyi I. P., Balan I. G.

    SURGICAL TREATMENT OF RECURRENCE OF PILONIDAL CYSTS OF THE SACROCOCCYGEAL AREA USING CROSSLINKED POLYURETHANE ADHESIVE AND IZOTRETINOIN

    About the author:

    Feleshtynskyi I. P., Balan I. G.

    Heading:

    CLINICAL AND EXPERIMENTAL MEDICINE

    Type of article:

    Scentific article

    Annotation:

    The aim was to improve treatment outcomes among patients with recurrence of pilonidal cyst of the sacrococcygeal area by comprehensive surgical treatment using cross-linked polyurethane adhesive and isotretinoin. Materials and methods. The analysis of surgical treatment of 120 patients with recurrence of pilonidal cyst of the sacrococcygeal area was carried out. The age of the patients ranged from 18 to 46 years; the average age was 27±1.2 years. The patients were divided into 2 groups depending on the method of treatment. In group 1 (60 patients), surgical treatment was carried out according to the method of economical median resection developed by the authors with double-row internal extraepidermal sutures in combination with a cross-linked polyurethane adhesive with immobilized albucide and prescription of isotretinoin at a dose of 0.5 mg/kg/d. In group 2 (60 patients), surgical treatment of pilonidal cysts was performed using the traditional method of median resection with interrupted cutaneous fixation sutures. The groups of patients were comparable in age and sex (p>0.05). The patients of both groups were prescribed antibiotic therapy: ciprofloxacin 500 mg and metronidazole 500 mg per os. All patients of both groups underwent surgical treatment under local anesthesia. Results and discussion. In the postoperative period, among 60 patients of group 1 who underwent surgical treatment according to the developed method in combination with the use of an adhesive composition, 3 (5%) patients had seroma of postoperative wound; there were no cases of wound infection, hematoma or recurrence of pilonidal cyst. Among 60 patients of group 2, 13 (21.7%) patients had seroma of postoperative wound. Postoperative wound infection was observed in 3 (5%) patients. The presence of hematoma was registered in 1 (1.7%) patient. Recurrence of the disease was observed in 9 (15%) patients in a period of 3 months to 2.5 years. A significant improvement of surgical treatment of pilonidal cysts was achieved in patients, who underwent surgery according to the developed method using an adhesive composition and medical therapy with antimicrobials and isotretinoin.

    Tags:

    pilonidal cyst,polyurethane adhesive,wound closure with tissue adhesives,isotretinoin.

    Bibliography:

    1. McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008 Apr 19;336(7649):868-871. DOI: 10.1136/bmj.39517. 808160.BE
    2. Yoldas T, Karaca C, Unalp O, Uguz A, Caliskan C, Akgun E, et al. Recurrent Pilonidal Sinus: Lay Open or Flap Closure, Does It Differ? Int. Surg. 2013;98(4):319-323. DOI: 10.9738/INTSURG-D-13-00081.1.
    3. Albabtain IT, Alkhaldi A, Aldosari L, Alsaadon L. Pilonidal sinus disease recurrence at a tertiary care center in Riyadh. Ann Saudi Med. 2021;41(3):179-185. DOI: 10.5144/0256-4947.2021.179.
    4. Halleran DR, Lopez JJ, Lawrence AE, Sebastião YV, Fischer BA, Cooper JN, et al. Recurrence of Pilonidal Disease: Our Best is Not Good Enough. J. Surg. Res. 2018 Dec;232:430-436. DOI: 10.1016/j.jss.2018.06.071.
    5. Badaoui A, Reygagne P, Cavelier-Balloy B, Pinquier L, Deschamps L, Crickx B, et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of literature. Br J Dermatol. 2016 Feb;174(2):421-423.
    6. Hon A, Amanda Oakley, Сlare Morrison. Follicular occlusion syndrome. DermNet; 2014. Available from: https://dermnetnz.org/.
    7. Sewon K, Masayuki A, Bruckner A, Enk A, Margolis D, Amy J, et al. Fitzpatrick’s Dermatology. Ninth Edition. McGraw Hill; 2019. 1866 p.
    8. Kubanov AA, Gallyamova YUA, Sysoyeva TA. Abstsediruyushchiy podryvayushchiy follikulit i perifollikulit Goffmana i sindrom follikulyarnoy okklyuzii. Lechashchiy vrach. 2017;8:69-73. Dostupno: https://www.lvrach. ru/2017/08/15436792.
    9. Scholz CF, Kilian M. The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus Propionibacterium to the proposed novel genera Acidipropionibacterium gen. nov., Cutibacterium gen. nov and Pseudopropionibacterium gen nov. Int J Syst Evol Microbiol. 2016;66:4422-4432.
    10. Jemec GBE, Revuz J, Leyden JJ. Hidradenitis Suppurativa. Berlin, Heidelberg: Springer; 2006. Chapter 17, Oral Retinoids for Hidradenitis Suppurativa; p. 128-135. DOI: https://doi.org/10.1007/978-3-540-33101-8_17.
    11. Halatenko NA, Kulyesh DV, Narazhayko LF, Hrytsenko VP, Zakashun TYu, Malets’kyy AP, et al. Doslidzhennya tsytotoksychnosti ta kyslotnosti ekstraktiv z syntetychnoho polimernoho materialu na osnovi sitchastoho poliuretanu z immobilizovanym al’butsydom v umovakh in vitro. Oftal’mol. zhurn. 2020;4:56-61. DOI: http://doi.org/10.31288/oftalmolzh202045661. [in Ukrainian].
    12. Halatenko NA, Rozhnova RA, Kulyesh DV, Vislohuzova TV, Malets’kyy AP, Bihun NM. Osoblyvosti reaktsiyi m’yakykh tkanyn i orhaniv cherevnoyi porozhnyny tvaryn (kroliv ta shchuriv) na implantatsiyu syntetychnoho polimernoho materialu na osnovi sitchastoho poliuretanu z immobilizovanym al’butsydom. Oftal’mol. zhurn. 2020;6:30-37. DOI: http://doi.org/10.31288/oftalmolzh202063037. [in Ukrainian].
    13. Feleshtyns’kyy YaP, Balan IH. Optymizatsiya khirurhichnoho likuvannya pilonidal’nykh kist kryzhovo-kuprykovoyi dilyanky. Khirurhiya Ukrayiny. 2019;4:33-39. DOI: https://doi.org/10.30978/SU2019-4-33. [in Ukrainian].
    14. Nelson AM, Gilliland KL, Cong Z, Thiboutot DM. 13-cis Retinoic acid induces apoptosis and cell cycle arrest in human SEB-1 sebocytes. J Invest Dermatol. 2006;126:2178-2189.
    15. Ganceviciene R, Zouboulis CC. Isotretinoin: state of the art treatment for acne vulgaris. J Dtsch Dermatol Ges. 2010;8(1):47-59.
    16. Dispenza MC, Wolpert EB, Gilliland KL, Dai JP, Cong Z, Nelson AM, et al. Systemic isotretinoin therapy normalizes exaggerated TLR-2- mediated innate immune responses in acne patients. J Invest Dermatol. 2012 Sep;132(9):2198-205. DOI: 10.1038/jid.2012.111.
    17. Karadag R, Karadag AS, Ozlu E, Oguztuzun S, Simsek GG, Esmer O. Effects of different doses of systemic isotretinoin on eyes: a histopathological and immunohistochemical study in rats. Cornea. 2020;39:621-627.
    18. Schroeder M, Zouboulis CC. All-trans-retinoic acid and 13-cis-retinoic acid: pharmacokinetics and biological activity in different cell culture models of human keratinocytes. Horm Metab Res. 2007;39:136-140.
    19. de Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. Journal of Visceral Surgery. 2013;150(4):237-247. DOI: https:// doi.org/10. 1016/j.jviscsurg.2013.05.006.

    Publication of the article:

    «Bulletin of problems biology and medicine» Issue 3 (166), 2022 year, 266-270 pages, index UDK 617-089.844:611.99

    DOI:

    10.29254/2077-4214-2022-3-166-266-270