Suture Techniques
Barbering
Surgical Flaps
Ambulatory Surgical Procedures
A fatal case of carcinoma arising from a pilonidal sinus tract. (1/51)
We report a male patient with carcinoma arising on the basis of neglected sacrococcygeal pilonidal sinus disease. Following initial operation, performed without suspicion of malignancy, histology demonstrated cellular atypia and an increased mitotic rate. A second, wider tissue excision was recommended but the patient declined further surgery. Two years later, he presented with fungating carcinoma involving the rectum but again declined surgery. This rare case demonstrates that the presence of carcinoma should be suspected in long-standing, although innocent-looking, pilonidal sinus disease. In the circumstance of uncertain histologic diagnosis, more generous surgical sampling is required. Every effort must be made to overcome patient's reluctance to accept a second, possibly life-saving procedure. (+info)Early sonographic detection of a 'human tail': a case report. (2/51)
We report on a newborn in whom an echogenic protrusion arising in the caudal region was detected at 12 weeks' gestation. Subsequent ultrasound examinations at weeks 15 and 22 failed to demonstrate this finding. After birth, the infant was found to have a pilonidal sinus. The pilonidal sinus may represent a remnant of the embryonic appendage ('human tail') that usually disappears by the end of the 8th week of gestation. This case might support the theory of congenital pilonidal sinus origin. (+info)Laser depilation of the natal cleft--an aid to healing the pilonidal sinus. (3/51)
BACKGROUND: Pilonidal disease is common. Excessive hair growth in the natal cleft is thought to be a factor in initiating these sinuses. It is chronic and intermittent in nature and treatment can be difficult. Hair removal by shaving or use of creams is often advised as a compliment to surgical treatments. However, access to the natal cleft can be difficult. Laser removal of hair in the natal cleft is considered as an aid to healing the pilonidal sinus. PATIENTS AND METHODS: Over a 5-year period, 14 patients with recurrent pilonidal disease were treated in our unit with laser depilation. They were all contacted by postal questionnaire, and those with ongoing disease were asked to return to the clinic for evaluation and possible further treatment. RESULTS: All patients returned the postal questionnaire. Of the 14 patients, 4 had on-going disease and received further depilation with the Alexandrite laser. All are now healed with no reported complications. All patients found the procedure painful and received local anaesthetic. CONCLUSIONS: Laser depilation in the natal cleft is by no means a cure for pilonidal disease. Removal of hair by this method represents an alternative and effective method of hair removal and, although long lasting, is only temporary. However, it allows the sinuses to heal rapidly. It is relatively safe, and simple to teach, with few complications. It should thus be considered as an aid to healing the problem pilonidal sinus. (+info)Silicone foam sponge for pilonidal sinus: a new technique for dressing open granulating wounds. (4/51)
A silicone foam sponge has been used to replace the daily packing of deep granulating wounds with moist sterile gauze. In the treatment of pilonidal sinus use of the sponge demands less nursing time and is more comfortable for the patient than the excision and open granulation technique. Patients can usually return to work soon after operation. The method has many applications in surgery, and widespread application of the technique to the management of granulating wounds could result in considerable savings to the NHS in money and skilled nursing time. (+info)Recurrent pilonidal cyst and sinus; a plan of preoperative preparation, operation and postoperative care. (5/51)
Evaluation ten years following radical excision and primary closure of recurrent pilonidal cysts led to the conclusion that the method of preoperative and postoperative care and the surgical technique employed gave satisfactory results. In 50 patients operated upon, the duration of symptoms varied from ten days to six years. Primary healing was achieved in all but one case in which there was slight skin overlapping. Thirty-three of the 50 patients were located for appraisal at the end of ten years. Three had had recurrences. The procedure involved eradication of acute infection preoperatively, wide, en bloc radical excision, with primary closure reattaching flaps centrally to the presacral fascia, and drainage of the depths of the wound. (+info)A randomised trial of knife versus diathermy in pilonidal disease. (6/51)
BACKGROUND: Pilonidal disease is a common debilitating condition. This prospective randomised study compared excision of pilonidal disease with a scalpel or diathermy with respect to operation time, postoperative pain, functional recovery and wound healing. PATIENTS AND METHODS: Patients undergoing surgery for pilonidal disease were randomised to excision by scalpel (group 1) or diathermy (group 2). Patients received regular peri-operative oral analgesia and a standardised general anaesthetic technique. Duration of operation was recorded. Following surgery, pain, analgesic requirements, sedation, nausea and vomiting scores and time to mobilise and time to complete healing were compared. RESULTS: Statistical significance between groups was obtained for five outcomes after 32 patients had been recruited; of these, 81% were admitted as emergencies with an abscess. The duration of surgery in group 2 was significantly less, postoperative pain scores and morphine requirements were lower and mobility was regained sooner. CONCLUSIONS: We advocate the use of diathermy needle rather than scalpel blade when undertaking excision of pilonidal disease in both acute and chronic patients. (+info)Radiofrequency incision and lay open technique of pilonidal sinus (clinical practice paper on modified technique). (7/51)
With the uncertainty as to the etiology and the complexities often encountered in its treatment, a pilonidal sinus has been considered as a tricky disease. Wide varieties of approaches are employed in dealing with this ailment ranging from a conservative treatment to an extensive surgical excision or repair. However, a method of simple lying open of pilonidal sinus is still considered as the favored one. We describe a modified approach to the procedure of incision and lying open the sinus tracts. This retrospective study describes 18 patients of chronic pilonidal sinus treated with a technique of radiofrequency surgery under local anesthesia. There were 12 males and 6 females within an age group ranging from 16 to 30. The patients were subjected to a follow-up for a period of 18 months. The patients were discharged on the same day of the procedure. Mean period off work was 7 days. The average healing time recorded was 67 days. Two wound complications in the form of premature closure of the skin edges were noted, requiring trimming of the edges. One of these two remained unhealed. At the last follow-up, no recurrence was found in the remaining 17 patients. In the era when the emphasis is on the criteria like minimum hospital stay, less postoperative pain, early resumption to work and a reduced recurrence rate, there is a future to the procedure of incision and lying open of the pilonidal sinuses by using the radiofrequency wave. (+info)Pilonidal sinus of the penis. (8/51)
A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin. (+info)A pilonidal sinus is a small hole or tunnel in the skin that usually develops in the cleft at the top of the buttocks. It can be painful and may become infected, causing symptoms such as redness, swelling, pain, and pus discharge. The condition often affects young adults and is more common in men than women.
The term "pilonidal" comes from the Latin words "pilus," meaning hair, and "nidus," meaning nest. This refers to the fact that the sinus often contains hairs that have become embedded in the skin. The exact cause of pilonidal sinuses is not known, but they are thought to develop as a result of ingrown hairs or chronic irritation in the affected area.
Treatment for pilonidal sinuses typically involves surgical removal of the sinus and any associated hair follicles. In some cases, this may be done using a minor procedure that can be performed in a doctor's office. More complex cases may require hospitalization and a more extensive surgical procedure. After surgery, patients will need to take steps to prevent the sinus from recurring, such as keeping the area clean and avoiding prolonged periods of sitting or driving.
The sacrococcygeal region is the lower part of the back where the spine ends, specifically referring to the area where the sacrum (a triangular bone at the base of the spine formed by the fusion of several vertebrae) meets the coccyx (also known as the tailbone). This region is located at the very bottom of the spine and is susceptible to injury or trauma due to its position and role in supporting the body's weight. It is also a common site for birth defects, particularly in newborns.
Suture techniques refer to the various methods used by surgeons to sew or stitch together tissues in the body after an injury, trauma, or surgical incision. The main goal of suturing is to approximate and hold the edges of the wound together, allowing for proper healing and minimizing scar formation.
There are several types of suture techniques, including:
1. Simple Interrupted Suture: This is one of the most basic suture techniques where the needle is passed through the tissue at a right angle, creating a loop that is then tightened to approximate the wound edges. Multiple stitches are placed along the length of the incision or wound.
2. Continuous Locking Suture: In this technique, the needle is passed continuously through the tissue in a zigzag pattern, with each stitch locking into the previous one. This creates a continuous line of sutures that provides strong tension and support to the wound edges.
3. Running Suture: Similar to the continuous locking suture, this technique involves passing the needle continuously through the tissue in a straight line. However, instead of locking each stitch, the needle is simply passed through the previous loop before being tightened. This creates a smooth and uninterrupted line of sutures that can be easily removed after healing.
4. Horizontal Mattress Suture: In this technique, two parallel stitches are placed horizontally across the wound edges, creating a "mattress" effect that provides additional support and tension to the wound. This is particularly useful in deep or irregularly shaped wounds.
5. Vertical Mattress Suture: Similar to the horizontal mattress suture, this technique involves placing two parallel stitches vertically across the wound edges. This creates a more pronounced "mattress" effect that can help reduce tension and minimize scarring.
6. Subcuticular Suture: In this technique, the needle is passed just below the surface of the skin, creating a smooth and barely visible line of sutures. This is particularly useful in cosmetic surgery or areas where minimizing scarring is important.
The choice of suture technique depends on various factors such as the location and size of the wound, the type of tissue involved, and the patient's individual needs and preferences. Proper suture placement and tension are crucial for optimal healing and aesthetic outcomes.
"Barbering" is a medical term that refers to the act of a bird or other animal feather-plucking or chewing on its own feathers, skin, or other animals' feathers or fur. This behavior can be a sign of various medical conditions, such as feather mites, nutritional deficiencies, or psychological disorders like feather-plucking syndrome. It is important to consult with a veterinarian if you notice barbering behavior in your bird or other animal, as it may indicate an underlying health issue that needs to be addressed.
Penile diseases refer to a range of medical conditions that affect the penis, including infections, inflammatory conditions, and structural abnormalities. Some common penile diseases include:
1. Balanitis: an infection or inflammation of the foreskin and/or head of the penis.
2. Balanoposthitis: an infection or inflammation of both the foreskin and the head of the penis.
3. Phimosis: a condition in which the foreskin is too tight to be pulled back over the head of the penis.
4. Paraphimosis: a medical emergency in which the foreskin becomes trapped behind the head of the penis and cannot be returned to its normal position.
5. Peyronie's disease: a condition characterized by the development of scar tissue inside the penis, leading to curvature during erections.
6. Erectile dysfunction: the inability to achieve or maintain an erection sufficient for sexual intercourse.
7. Penile cancer: a rare form of cancer that affects the skin and tissues of the penis.
These conditions can have various causes, including bacterial or fungal infections, sexually transmitted infections (STIs), skin conditions, trauma, or underlying medical conditions. Treatment for penile diseases varies depending on the specific condition and its severity, but may include medications, surgery, or lifestyle changes.
A surgical flap is a specialized type of surgical procedure where a section of living tissue (including skin, fat, muscle, and/or blood vessels) is lifted from its original site and moved to another location, while still maintaining a blood supply through its attached pedicle. This technique allows the surgeon to cover and reconstruct defects or wounds that cannot be closed easily with simple suturing or stapling.
Surgical flaps can be classified based on their vascularity, type of tissue involved, or method of transfer. The choice of using a specific type of surgical flap depends on the location and size of the defect, the patient's overall health, and the surgeon's expertise. Some common types of surgical flaps include:
1. Random-pattern flaps: These flaps are based on random blood vessels within the tissue and are typically used for smaller defects in areas with good vascularity, such as the face or scalp.
2. Axial pattern flaps: These flaps are designed based on a known major blood vessel and its branches, allowing them to cover larger defects or reach distant sites. Examples include the radial forearm flap and the anterolateral thigh flap.
3. Local flaps: These flaps involve tissue adjacent to the wound and can be further classified into advancement, rotation, transposition, and interpolation flaps based on their movement and orientation.
4. Distant flaps: These flaps are harvested from a distant site and then transferred to the defect after being tunneled beneath the skin or through a separate incision. Examples include the groin flap and the latissimus dorsi flap.
5. Free flaps: In these flaps, the tissue is completely detached from its original blood supply and then reattached at the new site using microvascular surgical techniques. This allows for greater flexibility in terms of reach and placement but requires specialized expertise and equipment.
Surgical flaps play a crucial role in reconstructive surgery, helping to restore form and function after trauma, tumor removal, or other conditions that result in tissue loss.
Actinomycosis is a type of infection caused by bacteria that are normally found in the mouth, intestines, and female genital tract. These bacteria can cause abscesses or chronic inflammation if they infect body tissues, often after trauma or surgery. The infection typically affects the face, neck, or chest, and can spread to other parts of the body over time. Symptoms may include swelling, redness, pain, and the formation of pus-filled abscesses that may discharge a characteristic yellowish granular material called "sulfur granules." Treatment typically involves long-term antibiotic therapy, often requiring high doses and intravenous administration. Surgical drainage or removal of infected tissue may also be necessary in some cases.
Ambulatory surgical procedures, also known as outpatient or same-day surgery, refer to medical operations that do not require an overnight hospital stay. These procedures are typically performed in a specialized ambulatory surgery center (ASC) or in a hospital-based outpatient department. Patients undergoing ambulatory surgical procedures receive anesthesia, undergo the operation, and recover enough to be discharged home on the same day of the procedure.
Examples of common ambulatory surgical procedures include:
1. Arthroscopy (joint scope examination and repair)
2. Cataract surgery
3. Colonoscopy and upper endoscopy
4. Dental surgery, such as wisdom tooth extraction
5. Gallbladder removal (cholecystectomy)
6. Hernia repair
7. Hysteroscopy (examination of the uterus)
8. Minor skin procedures, like biopsies and lesion removals
9. Orthopedic procedures, such as carpal tunnel release or joint injections
10. Pain management procedures, including epidural steroid injections and nerve blocks
11. Podiatric (foot and ankle) surgery
12. Tonsillectomy and adenoidectomy
Advancements in medical technology, minimally invasive surgical techniques, and improved anesthesia methods have contributed to the growth of ambulatory surgical procedures, offering patients a more convenient and cost-effective alternative to traditional inpatient surgeries.
Hair removal is the deliberate elimination or reduction of body hair. This can be achieved through various methods, both temporary and permanent. Some common temporary methods include shaving, waxing, tweezing, and depilatory creams. Permanent methods may involve laser hair removal or electrolysis, which target the hair follicle to prevent future growth. It's important to note that some methods can have side effects or risks, so it's recommended to consult with a healthcare professional or dermatologist before starting any new hair removal regimen.
Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.
Wound healing is a complex and dynamic process that occurs after tissue injury, aiming to restore the integrity and functionality of the damaged tissue. It involves a series of overlapping phases: hemostasis, inflammation, proliferation, and remodeling.
1. Hemostasis: This initial phase begins immediately after injury and involves the activation of the coagulation cascade to form a clot, which stabilizes the wound and prevents excessive blood loss.
2. Inflammation: Activated inflammatory cells, such as neutrophils and monocytes/macrophages, infiltrate the wound site to eliminate pathogens, remove debris, and release growth factors that promote healing. This phase typically lasts for 2-5 days post-injury.
3. Proliferation: In this phase, various cell types, including fibroblasts, endothelial cells, and keratinocytes, proliferate and migrate to the wound site to synthesize extracellular matrix (ECM) components, form new blood vessels (angiogenesis), and re-epithelialize the wounded area. This phase can last up to several weeks depending on the size and severity of the wound.
4. Remodeling: The final phase of wound healing involves the maturation and realignment of collagen fibers, leading to the restoration of tensile strength in the healed tissue. This process can continue for months to years after injury, although the tissue may never fully regain its original structure and function.
It is important to note that wound healing can be compromised by several factors, including age, nutrition, comorbidities (e.g., diabetes, vascular disease), and infection, which can result in delayed healing or non-healing chronic wounds.
Medically, hair is defined as a threadlike structure that grows from the follicles found in the skin of mammals. It is primarily made up of a protein called keratin and consists of three parts: the medulla (the innermost part or core), the cortex (middle layer containing keratin filaments) and the cuticle (outer layer of overlapping scales).
Hair growth occurs in cycles, with each cycle consisting of a growth phase (anagen), a transitional phase (catagen), and a resting phase (telogen). The length of hair is determined by the duration of the anagen phase.
While hair plays a crucial role in protecting the skin from external factors like UV radiation, temperature changes, and physical damage, it also serves as an essential aspect of human aesthetics and identity.
Pilonidal disease