Novel approach of treatment of pilonidal sinus disease

Pilonidalna bolest vrlo je česta bolest i prema literaturi 2% populacije zahvaćeno je bolešću u omjeru 2:1 u korist muškaraca. Iako bolest nije letalna, itekako narušava kvalitetu života. Etiologija je još nepoznata, ali postoje teorije koje bi trebale biti još dokazane. Postoje rizični čimbenici koji su povezani s bolešću, a to su: pretilost, dlakavost, higijena i oblik sakrokokcigealne regije. Terapija pilonidalne bolesti i dalje je kontroverzna tema. Potencijalno jedna od terapija bi mogla biti terapija zlatnog standarda, no ona još uvijek nije definirana. Bolest se može liječiti konzervativno ili kirurški. Konzervativnom terapijom pilonidalne bolesti smatramo terapiju antibioticima i lokalnu primjenu fenola ili fibrinskog ljepila. Kirurški pristup bolesti možemo podijeliti na otvorene rane, zatvorene rane (središnji šav, asimetrični šav, rekonstrukcije) i ostale metode (laser i endoskopska kirurgija). Usprkos širokoj raznolikosti kirurških tehnika kod liječenja pilonidalne bolesti, problem je u visokoj učestalosti pojave recidiva bolesti. U ovom diplomskom radu usporedit će se rezultati zadnjih studija o svim vrstama terapija za ovu bolest, s naglaskom na zadnje razvijene metode kao što su: konzervativno liječenje fibrinskim ljepilom, endoskopska metoda liječenja pilonidalnog sinusa i lokalna rekonstrukcija modificiranim Limbergovim režnjem.Pilonidal sinus disease is a very common disease and some literature estimates that 2% of the general population is affected by this disease at the ratio of 2:1 in favor of males. The disease is not lethal, but it is very annoying and decreases quality of life. Its etiology has not been understood yet but there are some theories that should be proven. There are some risk factors such as obesity, hairiness or the shape of the sacrococcygeal area. The therapy for this condition is still controversial. A golden standard for the treatment of this condition does not exist. It could be treated conservatively or surgicaly. Conservative treatment medically involves with oral antibiotics, hyoerbaric oxygen treatment and local injection of phenol acid or fibrin glue. Surgical treatment means that it could be performed by local excision of the pus without wound closure and secondary healing, primary closure or local reconstruction with a Limberg flap-closure. Despite the wide variety of surgical techniques to treat pilonidal sinus disease, high rates of recurrence are common. This article compares the last results from serval studies about all kinds of treatment for this condition, with a focus on most recent approaches such as conservative fibrin glue, endoscopic procedure, laser procedure and local reconstruction by modified Limberg flap-closure