Materiały źródłowe

• #1 Pilonidal Sinus Disease: 10 Steps to Optimize Care – PubMed

  https://pubmed.ncbi.nlm.nih.gov/27632444/

  Pilonidal sinus disease (PSD) is a common problem in young adults and particularly in males with a deep natal or intergluteal cleft and coarse body hair. […] An approach to an individual with PSD includes the assessment of pain, activities of daily living, the pilonidal sinus, and natal cleft. Local wound care includes the management of infection (if present), along with appropriate debridement and moisture management. Treatment is optimized with patient empowerment to manage the wound and periwound environment (cleansing, dressing changes, decontamination, hair removal, minimizing friction). Self-care education includes the recognition of recurrences or infection. Early surgical intervention of these wounds is often necessary for successful outcomes. Pilonidal sinus healing by secondary intention often takes weeks to months; however, the use of the Harris protocol may decrease healing times. A number of new surgical approaches may accelerate healing. Surgical closure by primary intention is often associated with higher recurrence rates. […] The authors have tabulated 10 key steps from the Harris protocol, including a review of the surgical techniques to improve PSD patient outcomes.

• #2 Pilonidal Sinus: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/pilonidal-cyst

  A pilonidal sinus infection mostly affects men and is also common in young adults. Its also more common in people who sit a lot, like cab drivers. […] If your case is diagnosed early on, you arent experiencing severe pain, and theres no sign of inflammation, its likely that your doctor will prescribe a broad-spectrum antibiotic. A broad-spectrum antibiotic is an antibiotic that treats a wide range of bacteria. […] Your doctor will recommend that you get a follow-up exam, regularly remove hair or shave the site, and pay particular attention to hygiene. […] After surgery, your doctor will explain how to change the dressings and will recommend shaving the site to prevent hair from growing into the wound. […] You can prevent a pilonidal sinus infection by washing the area on a daily basis with a mild soap, making sure all soap is removed, keeping the area completely dry, and avoiding sitting for long periods.

• #3 User Login

  https://www.jcn.co.uk/journals/issue/10-2015/article/nursing-management-of-pilonidal-sinus-in-the-community

  Pilonidal sinus is a benign disease that involves a sinus in the natal cleft. […] The management of pilonidal wounds can be challenging, but with a systematic approach to wound care that involves patients in their own care to help prevent infection and recurrence of this painful disorder, positive results can be achieved. […] Psychological care is just as essential as nursing care when managing this disease.

• #4 Pilonidal Cyst & Sinus: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/pilonidal-cyst-and-sinus/?srsltid=AfmBOoqiqLi00tI8tcd5oJLL2KqhbNamyrBz3R9sbmLxdfuqPROLL2cq

  Pilonidal Cyst and Sinus Nursing Care Plan […] Assessment […] Gather a medical history, including: […] Fever […] Risk factors […] Lower back pain […] Prolonged symptoms […] Previous cysts or abscesses […] Conduct a physical examination to check for: […] Pain […] Warmth […] Swelling […] Erythema […] Tenderness […] Tuft of hair […] Cellulitis […] Sacrococcygeal mass […] Presence of cyst or abscess […] Infection signs […] Sinus tract with purulent discharge […] Nursing Diagnoses […] Risk for acute pain related to cyst or abscess […] Risk for disturbed body image due to sacrococcygeal mass […] Risk for impaired tissue integrity due to cellulitis […] Risk for infection due to blocked hair follicle […] Interventions […] Preoperative and postoperative care

• #5 Pilonidal Cyst & Sinus: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/pilonidal-cyst-and-sinus/?srsltid=AfmBOoqiqLi00tI8tcd5oJLL2KqhbNamyrBz3R9sbmLxdfuqPROLL2cq

  Assist with hygiene of affected area […] Administer prescribed medications […] Position patient to avoid tailbone pressure […] Educate on prevention and proper wound care […] Monitor pain, wound healing, and infection signs […] Expected Outcomes […] No further signs of infection […] Reduced or absence of pain […] Improved or healed tissue integrity […] Resumption of normal activities without pain […] Effective coping with body image changes […] Patient/Caregiver Education […] Explain the condition, diagnosis, and treatment options […] Medications and side effects […] Importance of reporting recurrent symptoms […] Dressing change techniques for postoperative care […] Completing the full course of antibiotics when indicated […] Use of sitz baths for comfort […] Preventive measures for recurrence

• #6

  https://www.nursingcenter.com/journalarticle?Article_ID=3795974&Journal_ID=54015&Issue_ID=3775024

  PILONIDAL SINUS DISEASE (PSD) IS A COMMON PROBLEM IN YOUNG ADULTS AND PARTICULARLY IN MALES WITH A DEEP NATAL OR INTERGLUTEAL CLEFT AND COARSE BODY HAIR. […] LOCAL WOUND CARE INCLUDES THE MANAGEMENT OF INFECTION (IF PRESENT), ALONG WITH APPROPRIATE DEBRIDEMENT AND MOISTURE MANAGEMENT. […] TREATMENT IS OPTIMIZED WITH PATIENT EMPOWERMENT TO MANAGE THE WOUND AND PERIWOUND ENVIRONMENT (CLEANING, DRESSING CHANGES, DECONTAMINATION, HAIR REMOVAL, MINIMIZING FRICTION). […] SELF-CARE EDUCATION INCLUDES THE RECOGNITION OF RECURRENCES OR INFECTION. […] EARLY SURGICAL INTERVENTION OF THESE WOUNDS IS OFTEN NECESSARY FOR SUCCESSFUL OUTCOMES. […] PILONIDAL SINUS HEALING BY SECONDARY INTENTION OFTEN TAKES WEEKS TO MONTHS; HOWEVER, THE USE OF THE HARRIS PROTOCOL MAY DECREASE HEALING TIMES. […] A NUMBER OF NEW SURGICAL APPROACHES MAY ACCELERATE HEALING. […] SURGICAL CLOSURE BY PRIMARY INTENTION IS OFTEN ASSOCIATED WITH HIGHER RECURRENCE RATES. […] THE AUTHORS HAVE TABULATED 10 KEY STEPS FROM THE HARRIS PROTOCOL, INCLUDING A REVIEW OF THE SURGICAL TECHNIQUES TO IMPROVE PSD PATIENT OUTCOMES.

• #7 Pilonidal sinus surgery – After surgery | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/pilonidal-sinus-surgery/after-surgery

  Your recovery after surgery is slightly different depending on what type of surgery you had. […] You need someone to take you home and stay with you for at least 24 hours after surgery. It is important that you rest for the day to recover from the general anaesthetic. […] It is common to have some discomfort after surgery. The affected area can be quite painful for the first couple of days. […] If we give you painkillers, always follow the instructions on the packet or leaflet that comes with the medicine. […] The dressing on your wound depends on what type of surgery you had. […] Your surgeon might use stitches to close your wound after removing the pilonidal sinus. […] You have a dressing over your wound and sometimes a dressing inside the wound. This needs to be changed every day.

• #8 Living With Pilonidal Sinus- Things To Take Care Of – Pristyn Care

  https://www.pristyncare.com/blog/living-with-pilonidal-sinus-pc0441/

  Sitz baths and Epsom salt baths work amazingly in draining pus from the infected pilonidal cyst and also promote faster healing of the cyst. All you need to do is fill the bath with warm water and add 3-4 spoons of Epsom salt in it. Sit in the bathtub for 20 minutes. This would not only drain the cyst but also soothe the pain and itching in the region. […] For pilonidal sinus in the initial stages, the doctor usually prescribes certain antibiotics to prevent the cyst from getting infected. In addition to antibiotics, your doctor may also have prescribed some pain-relieving medicines. Take your medicines on time and in proper doses. Do not overdose and do not in any case self-medicate. […] However, you should remember that you can’t dodge the discomforts of pilonidal sinus for long. Therefore, you should consult a specialist doctor and get pilonidal sinus treated as soon as possible.

• #8 Living With Pilonidal Sinus- Things To Take Care Of – Pristyn Care

  https://www.pristyncare.com/blog/living-with-pilonidal-sinus-pc0441/

  The sooner you identify the symptoms of pilonidal sinus, the shorter you have to live with it. Not paying attention to pilonidal sinus in its initial stages can make it severe and create more problems for you. […] If you are dealing with pilonidal sinus, maintaining good hygiene becomes all the more important. Make sure you properly clean the area every day with mild soap and wash off all the soap properly. Avoid using harsh soaps as they can further irritate the cyst. Keep the buttocks regions clean and dry. Doing so will help reduce the risk of infections in the pilonidal cyst. […] Try to keep pressure off of the buttocks region as much as possible. Friction and excessive pressure can push more hair into the skin pits and further aggravate the condition of pilonidal sinus. For this purpose, you can also get yourself a coccyx pillow that will help minimize the pressure on the cyst region.

• #8 Living With Pilonidal Sinus- Things To Take Care Of – Pristyn Care

  https://www.pristyncare.com/blog/living-with-pilonidal-sinus-pc0441/

  Long sitting hours is one of the major risk factors for the pilonidal cyst. Prolonged sitting allows sweat and other particles to fester in the region and if these enter the skin pits, they can lead to infections in the cyst. Thus, if you are experiencing the troubles of pilonidal sinus, make sure you do not sit continuously for prolonged periods of time. […] If you have pilonidal sinus, paying attention to what you wear becomes very important. Avoid wearing clothes and undergarments that are too tight as these can rub against the pilonidal cyst and irritate it, thereby adding even more to your misery. Instead, prefer loose and comfortable clothes so that the contact between the skin and the clothes can be minimized. […] Refrain from indulging in high-intensity rigorous exercises. These can put extra strain on the buttocks region and can worsen the pain and discomfort of pilonidal sinus. Also, avoid lifting heavy weights and other friction-creating activities.

• #9 Pilonidal sinus surgery – After surgery | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/pilonidal-sinus-surgery/after-surgery

  Your nurse explains this to you in more detail and helps you to arrange care with your GP. […] You need to take at least 2 weeks off work until your follow-up appointment. During this time, it is important that you: […] Bathe the wound in a warm bath every day. Do not use soap, or put salt or any perfumed products in the water, until your wound has healed. This can irritate the wound. […] You need to visit the practice nurse at your GP surgery every day. They change your dressing and check the wound. […] Most people take 7 to 10 days off work after surgery. […] You can do as much as you feel that you can manage after surgery. However, it is important to avoid heavy activities until your body has a chance to recover. […] If your condition changes, you can start (initiate) a follow-up by contacting us. This is known as patient initiated follow-up (PIFU). If you have any concerns in the initial 6 months after your surgery, you can contact us by email: [email protected]

• #10 Pilonidal Disease Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/192668-treatment

  In Europe, pilonidal sinuses have been much more commonly treated with phenol injections than they have been in the United States. […] Phenol sterilizes the sinus tract and removes embedded hair. […] Because of the intense local inflammatory response after the phenol injection, patients usually stay in the hospital overnight. […] The wound should be cleansed daily in the shower or with a sitz bath. Paying close attention to hygiene and hair shaving of the surrounding area is important in preventing hair from penetrating the healing scar and causing further pilonidal sinuses to form. […] This meticulous treatment of the diseased area should continue for approximately 3 months, even after the wound has completely healed. […] When ID of an abscess is performed for pilonidal disease, the patient should be informed that this is not a curative procedure.

• #11 Management of complicated sacrococcygeal pilonidal sinus disease :: Cambridge Media Journals

  https://journals.cambridgemedia.com.au/wpr/volume-25-number-2/management-complicated-sacrococcygeal-pilonidal-sinus-disease

  This case study documents the treatment interventions and outcomes of a young man with complex pilonidal sinus (PNS) disease. […] Various wound care products were introduced with the aim of optimising wound bed preparation and healing. […] The patient was discharged with daily community nursing services attending to packing of the wound with a hydrofibre rope (Aquacel). […] The retained dressing was the result of irregularity in the staff allocated to review and attend to wound care, with several different nurses visiting the patient during the early treatment period. […] Following this incident the patient and family wanted consistency of care and decided to attend the outpatient wound clinic for ongoing assessment and management. […] Daily reviews were conducted by either the colorectal surgeon or STN and the patients mother was taught how to attend to wound dressings.

• #12 open pilonidal sinus wound wont close | Pilonidal Support Forums

  https://www.pilonidal.org/xfforums/threads/open-pilonidal-sinus-wound-wont-close.475/

  Hello, After exactly 10 months after an open pilonidal sinus surgery, i have had a hell of a time with it. When the district nurses came around in the few months after the surgery they used a packing material called Allevyn Cavity Plus. Never allow any one to use this material in your open cavity as it set me back several months and to this day i stil have a open wound. […] I have had success with Curasorb ribbon, which is a calcium alginate dressing. It absorbs exudate and I think debrides the wound at the same time. […] If your wound is blleding freqeuntly, this may be a sign that it is infected, as the bleeding may indicate the tissue is infected and therefore friable. […] You might want to talk to your doctor about a course of VAC (vaccuum assisted closure) – VAC pumps now come in a mobile form, and so you do not have to be in hospital to undergo a course of VAC therapy.

• #13 open pilonidal sinus wound wont close | Pilonidal Support Forums

  https://www.pilonidal.org/xfforums/threads/open-pilonidal-sinus-wound-wont-close.475/

  I have been packed with Aquacel Ribbon which helps to absorb the weeping, blood and anything else that comes out. I have also used Kaltostat that is used for bloody wounds. […] If you are still open at 10 months something is wrong. It is probable that the surgeon didn’t get the pits in the midline that is the source of the infection.

• #14 Pilonidal Disease Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/192668-treatment

  The recurrence rate is in the range of 8-21%. […] The average time for wound healing to occur is approximately 6 weeks. […] Many authors consider marsupialization to be the preferred method of treatment for chronic pilonidal disease because it avoids closure of a contaminated wound and combines shorter healing times with a lower recurrence rate. […] The patient still needs to pay meticulous attention to personal hygiene, with daily wound cleansing and frequent hair shaving and removal.

• #15 Pilonidal sinus

  https://www2.hse.ie/conditions/pilonidal-sinus/

  Your recovery time is usually between 4 to 6 weeks and you’ll need to have regular dressing changes. […] You will need to have surgery for a large or repeatedly infected sinus. […] Your recovery time is usually between 6 to 12 weeks. You’ll need to have regular dressing changes. […] There is a low risk of the sinus coming back. […] You will need to have surgery for a large or repeatedly infected sinus. […] There is a high risk of infection so the wound may need to be opened and dressings changed regularly. […] An endoscope (a thin, flexible tube with a camera on the end) is used to give a clear view of the affected area. […] You’ll have a follow-up appointment with your specialist after your surgery. […] keep the affected area clean […] wear comfortable, loose-fitting cotton underwear […] eat plenty of fibre to make going to the toilet easier and avoid straining […] do not lift heavy objects or do strenuous exercise for the first week or so […] do not ride a bike for 6 to 8 weeks […] do not go swimming until your wound has completely healed.

• #16 Pilonidal sinus: Symptoms, pictures, and treatment

  https://www.medicalnewstoday.com/articles/pilonidal-sinus

  A pilonidal sinus is a small tunnel that develops at the top of the crease in the buttocks. […] People with a pilonidal sinus need to take care of the area to prevent future abscesses and infections. […] If people do require treatment, it may include the following: […] In minor cases, hair removal may be the first step in treating a pilonidal sinus, if infection is not present. […] Research suggests that regular hair removal and maintaining good hygiene of the area may result in reduced surgical procedures and being able to return to normal activities. […] Following treatment, it is important that people keep any wound clean and dry, or use dressings for an open wound. It is also necessary to keep the buttocks crease and wound area free from hair. […] Treatment options include abscess drainage and surgical removal of the sinus, followed by frequent hair removal to help prevent future issues.

• #17

  https://drmaherabbas.com/pilonidal-wound-care/

  Pilonidal disease is a skin condition commonly referred to as a hair cyst. […] The treatment of pilonidal disease can range from incision and drainage of an abscess, removing the pits and sinus openings, laser treatment of the tracts, unroofing and marsupialization of the wound, to complex resection of the area with flap closure (moving healthy surrounding tissue to cover the wound). […] It is imperative that you follow all instructions and that you take daily care of your wound. […] Because of the location of pilonidal disease, you often will need the assistance of another person to care for your wound. […] Hair removal as described below is a critical part of your wound management. […] A major risk factor for non-healing or recurrence of pilonidal disease is hair infiltration of the wound.

• #18 Pilonidal sinus

  https://www.nhs.uk/conditions/pilonidal-sinus/

  A pilonidal sinus is a small hole or tunnel at the top of your bottom, between your buttocks. Treatment is usually only needed if it becomes infected. […] Treatment is not needed for a pilonidal sinus if there are no signs of infection. A „watch and wait” approach will be recommended. […] It’s very important to keep the area between your buttocks clean by showering or bathing regularly. […] If you have a painful, swollen abscess, it usually needs to be cut and the pus drained. You may also need antibiotics. […] You’ll need to have regular (daily) dressing changes. […] You’ll need to have regular dressing changes. […] Your care team will advise you about how to care for your wound while it heals and what to do if symptoms come back. […] keep the affected area clean […] wear comfortable, loose-fitting cotton underwear […] eat plenty of fibre to make going to the toilet easier and avoid straining […] do not lift heavy objects or do strenuous exercise for the first week or so […] do not ride a bike for 6 to 8 weeks […] do not go swimming until your wound has completely healed.

• #19

  https://drmaherabbas.com/pilonidal-wound-care/

  It is imperative that you are very diligent with hair removal from the wound and surrounding skin. […] Dr. Maher Abbas recommends hair removal during your recovery period and for at least 6 months after surgery until the scar of the wound is mature and complete. […] It is best to rest the first week following your surgery to allow the area to heal. […] Avoid excessive friction of the buttocks area and keep the area dry. […] You will be scheduled for weekly office follow-up visits until the wound is healed. […] The purpose of the visits is to inspect the wound, perform any debridement or hair removal if necessary. […] It is imperative that you show up to all your scheduled appointment to ensure proper wound care in order to maximize healing.

• #20 Pilonidal Disease Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/192668-treatment

  Concern surrounding long-term pilonidal disease is secondary to the rare occurrence of squamous cell carcinoma found in the pilonidal sinus tracts. […] No specific contraindications exist for the treatment of pilonidal disease. Acute infections should be drained; however, when more extensive procedures are required, every effort should be made to perform these in a noninfected field. […] There are several medical treatments for pilonidal sinuses. […] One of the simplest medical treatments of pilonidal sinuses is to shave the sacral area free of hair and to pluck all visible embedded hair in the sinus. […] The application of laser hair removal treatments to this region has been suggested as a means of reducing the likelihood of further exacerbations. […] The brushing of the tracts continues in the outpatient setting until the tract heals completely and closes.

• #21 Pilonidal Cyst and Sinus Treatment & Management: Emergency Department Care, Consultations, Medical Care

  https://emedicine.medscape.com/article/788127-treatment

  Patients with pilonidal disease without abscess or other significant symptoms should be discharged from the ED with reassurance and instructions to return if signs of an abscess develop. […] Patients should maintain adequate hygiene of the area and closely observe for infection. Current literature suggests there is no need for surgical intervention at this stage. […] Patients with evidence of cellulitis overlying the abscess should be treatment with antibiotics following drainage. […] Other than antibiotics in those with overlying cellulitis, the overall goal of nonoperative medical therapy is to remove hair and debris that may contribute to a chronic inflammatory state that keeps any potential skin tracts open. […] Surgical follow-up is recommended in 1-2 weeks. This allows the surgeon to examine the wound for healing, assess for potential recurrence, ensure that no other diagnosis and therapy should be considered, and arrange for definitive care of the sacrococcygeal region if necessary. […] Some literature suggests that conservative therapy with good local hygiene and site shaving every 1-3 weeks is as effective in preventing recurrence as a secondary surgical procedure.

• #22 Reducing the recurrence of pilonidal sinus disease | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/reducing-the-recurrence-of-pilonidal-sinus-disease-21-06-2013/

  Nurse practitioners should take the initiative and audit the outcomes of treatments, such as the use of razors or depilatory creams, and record recurrence rates to ensure we can give the best possible advice and treatment to our patients. […] There is a strong argument that more laser treatments should be available on the NHS to reduce the recurrence of this debilitating condition and the subsequent cost of surgery and hospitalisation. […] Multiple studies have shown laser hair removal decreases both short-term and long-term recurrence of the condition and this treatment should be considered in every case. […] Nurses are well placed to be involved in such studies.

• #22 Reducing the recurrence of pilonidal sinus disease | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/reducing-the-recurrence-of-pilonidal-sinus-disease-21-06-2013/

  Pilonidal sinus disease is usually treated by surgery, but can recur. Laser hair removal can make it less likely to return, and this procedure can be carried out by nurses […] Laser hair removal reduces the rate of recurrence by diminishing the number and thickness of hairs. It should be recommended along with personal hygiene measures for patients to reduce both short-term and long-term recurrence of the condition. […] Nurses are increasingly carrying out laser treatments for different medical conditions in hospitals and clinics in the UK. […] Nurses have the advantage over clinically unqualified operators in having knowledge of the condition and standard nursing skills. […] The nurse should reassure the patient and explain the treatment to gain fully informed consent, as well as provide information on how to care for the area and advice on lifestyle.

• #23 Living With Pilonidal Sinus- Things To Take Care Of – Pristyn Care

  https://www.pristyncare.com/blog/living-with-pilonidal-sinus-pc0441/

  Proper diagnosis and timely treatment will save you from any unpleasant complications so that you can lead a healthy and comforting life. […] Depending upon the severity of the condition, the treatment for pilonidal sinus can vary from home remedies to surgery. […] Living with pilonidal sinus can surely be difficult but a few lifestyle changes can help you get through it. Take proper precautions, eat healthy food, have a healthy lifestyle and seek medical consultation to get rid of pilonidal sinus faster.

• #24 How to Prevent Pilonidal Sinus?

  https://www.miracleshealth.com/blog/-how-to-prevent-pilonidal-sinus

  Pilonidal sinus can usually be prevented with simple lifestyle modifications and self-care practices. Here are some preventive tips: […] Maintain Proper Hygiene: Keep the area around your tailbone clean and free from bacteria. It is one of the most important steps in preventing pilonidal sinus. Hair and debris can accumulate in the area, which may lead to infection. […] Shave or Trim the Hair: Excess hair in the tailbone area can contribute to the development of a pilonidal sinus. When hair follicles get trapped under the skin, they can cause infections. […] Avoid Prolonged Sitting: Sitting for long periods can increase pressure on the tailbone area and raise the risk of developing a pilonidal sinus. People who work at desks or drive for long hours are especially at risk of this condition.

• #25 How to Prevent Pilonidal Sinus?

  https://www.miracleshealth.com/blog/-how-to-prevent-pilonidal-sinus

  Maintain a Healthy Weight: Being overweight or obese can increase the chance of pilonidal sinus. Excess body weight can lead to more friction and pressure in the area, making it more likely for a sinus to form. […] Keep the Area Dry and Clean: Moisture in the area around the tailbone can promote bacterial growth, which may lead to infection and the formation of a pilonidal sinus. Therefore, keeping the area dry is important. […] Avoid Excessive Sweating: Excessive sweating, especially in hot and humid environments, can increase the risk of pilonidal sinus due to moisture buildup. […] Regular Medical Checkups: If you have a history of pilonidal sinus or are concerned about developing one, regular checkups with a general surgery doctor is essential. They can monitor any changes in the area and provide early intervention if necessary.

• #26 Pilonidal sinus | Nursing Times

  https://www.nursingtimes.net/primary-care/pilonidal-sinus-08-04-2003/

  – Wounds that are left open to heal may take several weeks; requiring expert wound management, with daily attention at first until the wound begins to heal. […] – Nurses need to be aware of the psychological impact on individuals when this condition affects their social interactions and work-related activities. […] – Teaching patients preventative measures is important.

• #27 Management of complicated sacrococcygeal pilonidal sinus disease :: Cambridge Media Journals

  https://journals.cambridgemedia.com.au/wpr/volume-25-number-2/management-complicated-sacrococcygeal-pilonidal-sinus-disease

  A pain assessment and psychological assessment should be routinely incorporated into the treatment plan, with referral to the pain service or psychologist as appropriate. […] The psychological impact of having a chronic wound should not be underestimated and should be assessed as part of routine care with appropriate referrals made for supportive care. […] Patients require education regarding wound hygiene, the rationale for the interventions performed and the wound products chosen. […] Dressing changes were well tolerated and TNPWT continued for 18 days. […] The wound care product that led to the most significant improvement in both the wounds documented in this case was the silver polyurethane foam dressing; however, further studies into the effectiveness of this product in treating chronic PNS disease are required. […] Patients require access to consistent outpatient services for ongoing care and review. […] If the wound fails to heal and becomes chronic, further investigations and interventions must be conducted.

• #28 Pilonidal sinus disease

  http://www.worldwidewounds.com/2003/december/Miller/Pilonidal-Sinus.html

  The majority of acute cases do, however, require urgent operative intervention. […] Chronic disease can be successfully treated by shaving and meticulous hygiene, but recurrence rates are unknown. […] The principle management techniques will be discussed below. […] Following incision and drainage or excision procedures the wound should be packed with an alginate dressing. […] Hair and any debris should be removed at every wound inspection and the natal cleft should be kept hair free by weekly shaving or use of depilatory agents. […] Early signs of wound infection include increased pain and an abnormal dark 'beefy’ red appearance to the granulation tissue which is friable, bleeds on contact and exhibits superficial bridging. […] Prompt treatment with broad spectrum antibiotics such as metronidazole and erythromycin or clarithromycin is advised for a minimum of two weeks. […] Regardless of the surgical technique concerned, standard principles of wound care are essential with repeated depilation of the natal cleft, removal of hair and any debris from the wound bed and keeping the wound edges separated using an appropriate dressing.

• #29 Wound Clinics and Pilonidal Disease – Evergreen Surgical Pilonidal Clinic

  https://pilonidal.com/wound-clinics/

  If you are a clinician working in a wound clinic, it would not be uncommon for a surgeon to refer a patient to you with a non-healing wound after pilonidal surgery. Unfortunately, wounds in the gluteal crease are not like wounds elsewhere on the body, and the usual strategies for dealing with wounds may not apply here. […] The environment around the wound is the problem, and all attempts should be made to both control the environment and optimize healing. […] The area must be kept dry. This may be difficult with a weeping wound, but changing the woven gauze frequently will help. […] Attention should be given to the patients nutritional status. A high protein diet with appropriate vitamins and supplements is essential. […] If this is going to work, NO LONGER THAN 6-8 WEEKS SHOULD BE ALLOWED. After that time period, you are subjecting the patient to chronic wound care that is not necessary and very well may result in failure or recurrence. […] Although a surgeon may have referred the patient to you, and indicated that there is no surgical solution, that surgeon may not be aware of the success of the cleft-lift procedure in expert hands, and is not giving the patient the best advice.

• #30 Wound Care Options for the Pilonidal Cyst

  https://www.corkmedical.com/post/wound-care-options-for-the-pilonidal-cyst

  Sometimes failure to close after surgery may result in the patient’s having to return to surgery. Returning to surgery can complicate issues related to increased scar tissue, which does not heal as well as normal tissue. If surgical revision is not an option or has been attempted more than once with no closure of the wound, the goals for this wound then become to manage infection, attempt to reduce or maintain size of wound, provide appropriate dressing materials that optimize ease of care, minimize pain through the use of comfortable dressings and topical anesthetics, and routinely monitor the wound. […] Advanced therapies may also be utilized to reduce the size of the wound. The patient’s nutrition should be addressed to ensure that he or she is eating the proper foods and getting adequate hydration. As with any non-healing wound, a wound culture would be warranted, as well as a biopsy, to rule out any malignancy. Other comorbidities should be addressed such as diabetes, smoking, and the use of anticoagulants.

• #31

  https://link.springer.com/article/10.1007/s13304-024-01799-2

  The use of phenol as a sclerosing agent to destroy debris within the sinus tract and cavity was first described in 1964 and can be a standalone treatment or a supplementary approach to surgery. […] Initially described as a technique to be performed in an outpatient setting with local anesthetic, the Bascom pit-picking and lateral drainage has been used internationally for over 40 years. […] Leaving the wound open to heal by secondary intention after an excision is an accepted variation. […] Given the concerns surrounding midline closures, as well as the observation that hairs only insert themselves in the natal cleft, Karydakis developed a technique aimed at shifting wounds off the midline while removing the deep gluteal cleft itself. […] Overall, the technique used for the Karydakis procedure remains variable in multiple aspects.

• #32 Diagnosis, treatment and nursing management of patients with pilonidal sinus disease. – Document – Gale OneFile: Health and Medicine

  https://go.gale.com/ps/i.do?id=GALE%7CA169133819&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00296570&p=HRCA&sw=w

  Pilonidal sinus disease is a common disorder that occurs in the cleavage between the buttocks and can cause discomfort and embarrassment for patients. It frequently recurs following surgery and requires time-consuming wound care. […] This article discusses the incidence, pathophysiology, clinical presentation and appropriate management of patients with the disease. […] The aim of this article is to examine the incidence, pathophysiology and main management strategies that may be used for patients with pilonidal sinus disease. […] Discuss some of the key management strategies for patients with pilonidal sinus disease. […] Consider the role of the nurse in the care of patients with the disease. […] Despite being a common problem, little research has been carried out on the role of the nurse in caring for patients with pilonidal sinus disease.

• #33

  https://journals.lww.com/aswcjournal/fulltext/2012/07000/twelve_common_mistakes_in_pilonidal_sinus_care.9.aspx

  To enhance the learners competence with knowledge of 12 common mistakes in pilonidal sinus care. […] After participating in this educational activity, the participant should be better able to: […] Demonstrate knowledge of pilonidal sinus care and the 12 common mistakes associated with this care. […] Apply research-based information to educating patients about self-care for pilonidal sinus wounds. […] The continuing education activity outlines 12 common mistakes the authors believe are key barriers to the success in healing pilonidal sinus care. […] The authors review of commonly observed mistakes, and rationale for diagnosis and treatment from the literature review, observations, and practical applications of knowledge from the authors will enhance the clinicians approach to PSW management.

• #34

  https://www.nursingcenter.com/journalarticle?Article_ID=1365502&Journal_ID=54015&Issue_ID=1365324

  PURPOSE: To enhance the learner’s competence with knowledge of 12 common mistakes in pilonidal sinus care. […] OBJECTIVES: After participating in this educational activity, the participant should be better able to: […] 1. Demonstrate knowledge of pilonidal sinus care and the 12 common mistakes associated with this care. […] 2. Apply research-based information to educating patients about self-care for pilonidal sinus wounds. […] Twelve leading mistakes in assessment and treatment have been identified with appropriate solutions to optimize patient outcomes.

• #35

  https://journals.lww.com/aswcjournal/fulltext/2016/10000/pilonidal_sinus_disease__10_steps_to_optimize_care.10.aspx

  The authors recommend that wound debridement can be accomplished by several more effective methods, which may be used concurrently including the following: curetting or conservative debridement with a curette or iris scissors to remove surface abnormal red friable granulation after suitable pain control with oral pain control or local anesthetic agents: intralesional xylocaine with or without adrenaline and topical anesthetic agents containing amine local anaesthetics (xylocaine, prilocane, pramoxine). […] Patient education is aimed at self-management keeping the NC skin clean, removing unwanted peri-pilonidal sinus skin hair, which often carries S aureus, and managing the exudate and odor. […] Pilonidal sinus wounds need to be kept clean and dry. Baths should be avoided, and showering using liquid antimicrobial soap substitutes and handheld shower heads are preferred for cleansing, once or twice per day. […] Appropriate surgical management is paramount to the treatment of PSWs. Although not covered in the Harris protocol, it was understood that a surgical procedure preceded the need for care, as part of treat the cause.

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