title: Novel Approach of Treatment of Pilonidal Sinus Disease With Thrombin Gelatin Matrix as a Sealant.
abstract: BACKGROUND
  Sacrococcygeal pilonidal sinus disease is a condition caused by insertion of fallen hair shafts into the skin. Different types of operations have been described for the management of pilonidal sinus, yet none of them have proven to be superior to the others. Recently, sealants like fibrin glue have been successfully used.
  
  
  OBJECTIVE
  This study aimed to assess the efficacy of thrombin gelatin matrix as a new sealant for pilonidal sinus treatment.
  
  
  METHODS
  This was a prospective study conducted from March 2013 to March 2015.
  
  
  METHODS
  The study was conducted in private hospitals in Mansoura City.
  
  
  METHODS
  The study included 36 male patients (72%) and 14 female patients (28%), with a median age of 22 years.
  
  
  METHODS
  Fifty patients with pilonidal sinus were admitted and treated with thrombin gelatin matrix injection.
  
  
  METHODS
  Incidence and time of pilonidal sinus recurrence, postoperative pain and complications, duration of hospital stay, healing status, and time to return to work were recorded.
  
  
  RESULTS
  The median duration of symptoms was 13 months, median operative time was 18 minutes, and median hospital stay was 6 hours. All of the procedures were conducted as day-case surgeries. Median follow-up duration was 24 months. Three patients (6%) had a breakdown of the sealant, and the wound was managed with daily dressings. Recurrence at 1 year was observed in 2 patients (4%). A total of 96% of patients were satisfied with the outcome of the procedure, and 92% of patients resumed their daily activities within 3 days.
  
  
  CONCLUSIONS
  Follow-up for a longer duration is required to ascertain the efficacy of this new technique. The cost of this treatment might be challenging for resource-limited communities.
  
  
  CONCLUSIONS
  Management of pilonidal sinus using thrombin gelatin matrix, despite being expensive, is an effective, simple treatment that is easy to perform and associated with low recurrence rate, minimal morbidity, and rapid recovery.
authors.affiliation: General Surgery Department, Faculty of Medicine, Mansoura University Hospitals, Mansoura City, Egypt.
authors.forename: Hosam G
authors.initials: HG
authors.lastname: Elbanna
authors.forename: Sameh Hany
authors.initials: SH
authors.lastname: Emile
authors.forename: Mohamed
authors.initials: M
authors.lastname: Youssef
authors.forename: Waleed
authors.initials: W
authors.lastname: Thabet
authors.forename: Tito M Abd
authors.initials: TM
authors.lastname: El-Hamed
authors.forename: Wagih M
authors.initials: WM
authors.lastname: Ghnnam
mesh_terms: D000293:Adolescent; D000328:Adult; D003475:Curettage; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010864:Pilonidal Sinus / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D013917:Thrombin / Q000627:therapeutic use*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014014:Tissue Adhesives; D005780:Gelatin; D013917:Thrombin