S3-Leitlinie: Sinus pilonidalis

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• 作者：Dr. A. Ommer (1)
  E. Berg (2)
  C. Breitkopf (2)
  D. Bussen (2)
  D. Doll (2)
  A. F眉rst (2)
  A. Herold (2)
  F. Hetzer (2)
  T.H. Jacobi (2)
  H. Krammer (2)
  B.H. Lenhard (2)
  G. Osterholzer (2)
  S. Petersen (2)
  R. Ruppert (2)
  O. Schwandner (2)
  M. Sailer (2)
  T.H.K. Schiedeck (2)
  M. Schmidt-Lauber (2)
  M. Stoll (2)
  B. Strittmatter (2)
  I. Iesalnieks (2)
  
• 关键词：Sinus pilonidalis ; Pilonidalsinusabszess ; Diagnostik ; Operative Therapie ; Stei脽beinfistel ; Pilonidal sinus ; Pilonidal abscess ; Diagnostics ; Surgery ; Coccygeal fistula
• 刊名：coloproctology
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：36
• 期：4
• 页码：272-322
• 全文大小：4,812 KB
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• 作者单位：Dr. A. Ommer (1)
  E. Berg (2)
  C. Breitkopf (2)
  D. Bussen (2)
  D. Doll (2)
  A. F眉rst (2)
  A. Herold (2)
  F. Hetzer (2)
  T.H. Jacobi (2)
  H. Krammer (2)
  B.H. Lenhard (2)
  G. Osterholzer (2)
  S. Petersen (2)
  R. Ruppert (2)
  O. Schwandner (2)
  M. Sailer (2)
  T.H.K. Schiedeck (2)
  M. Schmidt-Lauber (2)
  M. Stoll (2)
  B. Strittmatter (2)
  I. Iesalnieks (2)
  
  1. End- und Dickdarm-Zentrum Essen, R眉ttenscheider Str. 66, 45130, Essen, Deutschland
  2. -, -, Deutschland
  
• ISSN：1615-6730

文摘

Background The pilonidal sinus is an acquired disease of hair follicles. The aim of the present guidelines is to compare various treatment methods and to assist physicians with evidence-based recommendations. Methods A systemic literature review was carried out. The present guidelines were reviewed and accepted by a consensus conference. Results There are three types of disease manifestation: an asymptomatic condition, acute abscess and chronic pilonidal disease. The latter is the most frequent type of presentation. At present, there is no treatment method fulfilling all desired criteria: a simple, painless procedure associated with rapid wound healing and a low recurrence rate. Conclusion An asymptomatic pilonidal disease does not necessitate any treatment. A pilonidal abscess should initially be locally incised followed by one of the definitive treatment methods after regression of the acute inflammation. A primary complete excision of the abscess and open wound treatment is associated with a prolonged healing time. An excision of the pilonidal abscess and primary wound closure is associated with increased morbidity and recurrence rate and should be avoided. The basic treatment method of chronic pilonidal disease is surgical excision. Open wound treatment after pilonidal excision is associated with a low postoperative morbidity; however, this method is complicated by a considerably prolonged wound healing. Minimally invasive procedures (e.g. pit picking surgery) represent a treatment option for chronic pilonidal disease; however, the recurrence rate is higher compared to open procedures. Excision followed by a primary midline wound closure bears no advantages to other methods and should be avoided. An off-midline surgical approach can be adopted as a primary treatment option in chronic pilonidal disease. At present, there is no evidence of any outcome differences between various off-midline procedures. The Limberg flap and the Karydakis procedure are the two best described methods.