Pilonidal sinüs hastalığının tedavisinde kristalize fenol ve gümüş nitrat uygulamasının karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Pilonidal sinüs hastalığında kliniğimizde de uyguladığımız, kolay uygulanan, yatış
gerektirmeyen, iş gücü kaybına neden olmayan, yara bakımı ve pansuman gerektirmeyen
bir çok çalışmada etkinliği ispatlanmış konservatif tedavi yöntemlerinden kristalize fenol
ile zor yaraların tedavisinde kullanılan, yara iyileşmesini hızlandıran litik ajan gümüş nitrat
uygulamasının etkinliklerinin prospektif olarak karşılaştırılması amaçlanmıştır.
Materyal ve Metod: Şubat 2017 ile Mayıs 2021 tarihleri arasında, Meram Tıp Fakültesi
Hastanesi Genel Cerrahi Poliklinikleri'ne başvuran pilonidal sinüs hastalığı tanısı konan ve
nonoperatif tedavi uygulanan 100 hasta değerlendirmeye alınarak yapılmıştır.
Kontrollerine gelmeyen veya ulaşılamayan 10 hastanın verileri çalışmadan çıkarıldı.
Böylece toplam 90 hastaya ait demografik bilgiler (yaş, cinsiyet, ten rengi, vücut kitle
indeksi, sigara, diyabet, aile öyküsü, meslek), hastalıktan kaynaklanan şikayet ve süresi,
kaç adet sinus deliği olduğu, kaç kez tedavi uygulandığı, işlem sonrası komplikasyon
gelişip gelişmediği kaydedildi. Hastalar hastaneye ilk başvuru zamanlarına göre randomize
olarak kristalize fenol veya gümüş nitrat tedavisine yönlendirildi. Çalışmaya katılan
hastaların tedavi süreçleri ve işlem sayıları ayrıntılı olarak kaydedildi.
Bulgular: Kristalize fenol uygulanan hastaların yaş ortalaması 22,5 (+7,5), gümüş nitrat
tedavisi uygulanan hastaların yaş ortalaması 25 (+7,5) olarak saptandı. Hastaların
şikayetleri dağılımında en sık 34'ünde (%37,8) akıntı mevcuttu, 30'unda (%33,3) ağrı ile
birlikte akıntı mevcuttu. Şikayet süreleri değerlendirildiğinde hastaların 27(%30)’sinin
şikayet süresinin 12-24 ay arasında olduğu, 22 (%24,4)’sinin 24 aydan daha fazla olduğu
Aim: A prospective study of the effectiveness of the lytic agent silver nitrate used in the treatment of difficult wounds with crystallized phenol, one of the conservative treatment methods whose effectiveness has been proven in many studies in pilonidal sinus disease, which is easy to apply, does not require hospitalization, does not cause loss of work power, and does not require wound care and dressing. intended to be compared. Material and Method: Between February 2017 and May 2021, 100 patients diagnosed with pilonidal sinus disease and treated nonoperatively, who applied to the General Surgery Polyclinics of Meram Medical Faculty Hospital, were evaluated. The data of 10 patients who did not come to their controls or could not be reached were excluded from the study. Thus, the demographic information of 90 patients (age, gender, skin color, body mass index, smoking, diabetes, family history, occupation), complaints and duration of the disease, how many sinus holes, how many treatments were applied, whether complications developed after the procedure or not. not developed was noted. Patients were randomly assigned to crystallized phenol or silver nitrate treatment according to their first admission to the hospital. The treatment processes and the number of procedures of the patients participating in the study were recorded in detail. Results: The mean age of the patients who were treated with crystalline phenol was 22.5 (+7.5), and the mean age of the patients who were treated with silver nitrate was 25 (+7.5). In the distribution of the complaints of the patients, 34 (37.8%) most frequently had discharge, 30 (33.3%) had discharge with pain. When the duration of complaints was evaluated, it was seen that 27 (30%) of the patients had complaints between 12-24 months, and 22 (24.4%) had more than 24 months. In terms of the number of sinuses, the most v common sinuses were 2 sinus holes in 42 (46.7%), 3 sinus holes in 18 (20%), 1 sinus hole in 17 (18.9%), and 13 (14%, 14%) patients. 4) There were 4 sinus holes. In the first-year controls of the patients, 46 (92%) of the patients who received crystallized phenol improved, 2 (4%) did not improve, and 2 (4%) relapsed. Recovery was observed in 38 (95%) of the patients treated with silver nitrate, 1 (2.5%) did not improve, 1 (2.5%) had recurrence. Conclusion: Considering the increasing experience, newly developed techniques and patient comfort in the treatment of pilonidal sinus disease, minimally invasive interventions are increasing. In this sense, the most commonly used non-operative method is crystallized phenol treatment. Pilonidal sinus treatment with silver nitrate has the advantages of being outpatient, not requiring hospitalization, and providing full recovery in the early period, just like in crystallized phenol treatment. However, it has advantages over crystallized phenol application in terms of storage conditions, ease of application and cost. With these aspects, pilonidal sinus treatment with silver nitrate is a candidate to be an alternative or ideal treatment method to crystallized phenol treatment.
Aim: A prospective study of the effectiveness of the lytic agent silver nitrate used in the treatment of difficult wounds with crystallized phenol, one of the conservative treatment methods whose effectiveness has been proven in many studies in pilonidal sinus disease, which is easy to apply, does not require hospitalization, does not cause loss of work power, and does not require wound care and dressing. intended to be compared. Material and Method: Between February 2017 and May 2021, 100 patients diagnosed with pilonidal sinus disease and treated nonoperatively, who applied to the General Surgery Polyclinics of Meram Medical Faculty Hospital, were evaluated. The data of 10 patients who did not come to their controls or could not be reached were excluded from the study. Thus, the demographic information of 90 patients (age, gender, skin color, body mass index, smoking, diabetes, family history, occupation), complaints and duration of the disease, how many sinus holes, how many treatments were applied, whether complications developed after the procedure or not. not developed was noted. Patients were randomly assigned to crystallized phenol or silver nitrate treatment according to their first admission to the hospital. The treatment processes and the number of procedures of the patients participating in the study were recorded in detail. Results: The mean age of the patients who were treated with crystalline phenol was 22.5 (+7.5), and the mean age of the patients who were treated with silver nitrate was 25 (+7.5). In the distribution of the complaints of the patients, 34 (37.8%) most frequently had discharge, 30 (33.3%) had discharge with pain. When the duration of complaints was evaluated, it was seen that 27 (30%) of the patients had complaints between 12-24 months, and 22 (24.4%) had more than 24 months. In terms of the number of sinuses, the most v common sinuses were 2 sinus holes in 42 (46.7%), 3 sinus holes in 18 (20%), 1 sinus hole in 17 (18.9%), and 13 (14%, 14%) patients. 4) There were 4 sinus holes. In the first-year controls of the patients, 46 (92%) of the patients who received crystallized phenol improved, 2 (4%) did not improve, and 2 (4%) relapsed. Recovery was observed in 38 (95%) of the patients treated with silver nitrate, 1 (2.5%) did not improve, 1 (2.5%) had recurrence. Conclusion: Considering the increasing experience, newly developed techniques and patient comfort in the treatment of pilonidal sinus disease, minimally invasive interventions are increasing. In this sense, the most commonly used non-operative method is crystallized phenol treatment. Pilonidal sinus treatment with silver nitrate has the advantages of being outpatient, not requiring hospitalization, and providing full recovery in the early period, just like in crystallized phenol treatment. However, it has advantages over crystallized phenol application in terms of storage conditions, ease of application and cost. With these aspects, pilonidal sinus treatment with silver nitrate is a candidate to be an alternative or ideal treatment method to crystallized phenol treatment.
Açıklama
Anahtar Kelimeler
Pilonidal sinüs, Kristalize fenol, Gümüş nitrat, Pilonidal sinus, Crystalline phenol, Silver nitrate
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kocamaz, A. H. (2021). Pilonidal sinüs hastalığının tedavisinde kristalize fenol ve gümüş nitrat uygulamasının karşılaştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Genel Cerrahi Anabilim Dalı, Konya.
