Fibrin glue obliteration is safe, effective and minimally invasive as first line treatment for pilonidal sinus disease in children.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 30 05 2018
accepted: 31 07 2018
pubmed: 1 10 2018
medline: 4 12 2019
entrez: 1 10 2018
Statut: ppublish

Résumé

Sacrococcygeal pilonidal sinus disease (PSD) has an incidence of 1.2-2.5/1000 in children. Onset is around puberty. Symptoms of recurrent abscess and chronic suppuration may interfere with education and social integration. Treatments should cause minimal disruption while having good cure and recurrence rates. Curettage and Fibrin glue obliteration (FGO) show promising results in adults. We present our experience of its use in children. Review of all pediatric patients receiving FGO of pilonidal sinus performed by a single surgeon from September 2014 to February 2018. Eighteen patients were identified. Median age was 16 (range 15-17), 55.6% were male. All procedures were completed as day cases. Median operative duration was 14 .1 (6-29) min. Twelve patients required only 1 procedure, 4 required 2 procedures, 1 required 5 procedures and 1 elected for formal excision after 2 FGO treatments. Median return to normal activities was 3 days, with 1 day school absence. Two patients developed minor surgical site infections. Median follow-up was 52 weeks (17-102), during which time there was 1 recurrence (5.6%). This study demonstrates FGO is a safe, effective procedure for pediatric PNS, with results comparable to off-midline flap techniques and without the need for extensive tissue excision and the associated morbidity. IV.

Sections du résumé

BACKGROUND / PURPOSE UNASSIGNED
Sacrococcygeal pilonidal sinus disease (PSD) has an incidence of 1.2-2.5/1000 in children. Onset is around puberty. Symptoms of recurrent abscess and chronic suppuration may interfere with education and social integration. Treatments should cause minimal disruption while having good cure and recurrence rates. Curettage and Fibrin glue obliteration (FGO) show promising results in adults. We present our experience of its use in children.
METHODS METHODS
Review of all pediatric patients receiving FGO of pilonidal sinus performed by a single surgeon from September 2014 to February 2018.
RESULTS RESULTS
Eighteen patients were identified. Median age was 16 (range 15-17), 55.6% were male. All procedures were completed as day cases. Median operative duration was 14 .1 (6-29) min. Twelve patients required only 1 procedure, 4 required 2 procedures, 1 required 5 procedures and 1 elected for formal excision after 2 FGO treatments. Median return to normal activities was 3 days, with 1 day school absence. Two patients developed minor surgical site infections. Median follow-up was 52 weeks (17-102), during which time there was 1 recurrence (5.6%).
CONCLUSION CONCLUSIONS
This study demonstrates FGO is a safe, effective procedure for pediatric PNS, with results comparable to off-midline flap techniques and without the need for extensive tissue excision and the associated morbidity.
LEVEL OF EVIDENCE METHODS
IV.

Identifiants

pubmed: 30268489
pii: S0022-3468(18)30546-3
doi: 10.1016/j.jpedsurg.2018.07.024
pii:
doi:

Substances chimiques

Fibrin Tissue Adhesive 0
Tissue Adhesives 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1668-1670

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Ejo Hardy (E)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT. Electronic address: edward.hardy@nhs.net.

Pjj Herrod (P)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT.

T Sian (T)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT.

H Boyd-Carson (H)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT.

Jem Blackwell (J)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT.

J N Lund (JN)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 2DT.

J W Quarmby (JW)

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2.

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