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

Abstract

BACKGROUND / PURPOSE:

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:

Review of all pediatric patients receiving FGO of pilonidal sinus performed by a single surgeon from September 2014 to February 2018.

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:

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:

IV.

• Authors: Ejo Hardy, Pjj Herrod, T Sian, H Boyd-Carson, Jem Blackwell, J N Lund, J W Quarmby
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 54 Issue 8 Pg. 1668-1670 (Aug 2019) ISSN: 1531-5037 [Electronic] United States
• PMID: 30268489 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Fibrin Tissue Adhesive
• Tissue Adhesives

Topics

• Adolescent
• Female
• Fibrin Tissue Adhesive (adverse effects, therapeutic use)
• Humans
• Male
• Operative Time
• Pilonidal Sinus (surgery)
• Recurrence
• Reoperation
• Retrospective Studies
• Surgical Wound Infection (etiology)
• Tissue Adhesives (adverse effects, therapeutic use)