Long-Term Outcomes of Crystallized Phenol Application after Punch Excision for the Treatment of Pilonidal Sinus Disease

• Published in: The American surgeon Vol. 85; no. 11; pp. 1219 - 1223
• Main Authors: Demirel, Arif Hakan, Polat, Mikail
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2019; SAGE PUBLICATIONS, INC
• Subjects: Administration, Topical; Adolescent; Adult; Anesthesia; Biopsy; Biopsy - instrumentation; Crystallization; Female; Humans; Male; Medical treatment; Middle Aged; Patients; Phenol - administration & dosage; Phenols; Pilonidal Sinus - pathology; Pilonidal Sinus - therapy; Prospective Studies; Recurrence; Sinuses; Surgery; Tempering; Treatment Outcome; Young Adult
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481908501126

The aim of the study was to present the outcomes of topical crystallized phenol application in the treatment of pilonidal sinus disease. Under local anesthesia, a punch biopsy tool is used for the excision of the sinus opening holes; after cleaning the cavity, 150 to 250 mg of crystallized phenol was administered. Three sessions of additional therapy were given one week apart without anesthesia. The technique was well tolerated, and early results were observed two months after the procedure. Recurrence was detected in five patients (11.9%), one of whom underwent two more sessions, resulting in recovery. In the long-term results, 39 patients were available after 16 to 38 months (mean 23.7 months). Of these, recurrence was detected in five patients (12.8%). Analysis of the data was unable to identify significant effects of the characteristics of the disease (primary or recurrent), gender of patients, and the number of opening holes (single or multiple) on early and late recurrence (P > 0.05). A close correlation can be drawn from the early- and long-term results after treatment (P < 0.0001). In this study, the use of the punch biopsy tool in the treatment of pilonidal sinus disease with crystallized phenol was described first. This minimally invasive method achieved excellent aesthetic outcomes, and it can successfully be applied without the need for surgical intervention, especially in patients who are at the initial stage and with small in size openings.