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Birinci basamakta pilonidal hastalığa yaklaşım

Year 2007, Volume: 14 Issue: 3, 48 - 51, 06.05.2009

Abstract

Süleyman Demirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2007 Eylül; 14(3)








Birinci basamakta pilonidal hastalığa yaklaşım



Kurtuluş Öngel, Ebru Katırcı, Cennet Ak, İsmail Sarıkan



Süleyman Demirel Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı



Özet



Toplumumuzda yaygın olarak görülen pilonidal hastalık, halk arasında kıl dönmesi. Olarak isimlendirilmektedir. Bir kıl kökünün iltihaplanması ve diğer kıl köklerini de içine alarak abse oluşturması ile karakterizedir. ABD. de her yıl yaklaşık 75000 hasta ve binlerce operasyon nedenidir. Hastanede elektif tedaviyle, tedavi süresi ortalama 1.5 gündür. Meslekle ilişkili olduğu bilinmektedir (Devamlı bilgisayar başında oturanlarda ya da uzun süre araba kullananlarda daha sık). Bireylerin sağlık sorunları konusunda öncelikle bağlı bulundukları birinci basamak hekimlerine başvurduklarını düşünürsek, pilonidal sinus hastalığının da tanı, tedavi ve izlemi aşamasında bu gruba büyük görevler düşmektedir. Birinci basamakta kuyruk sokumunda şişkinlik, kızarıklık ve ağrı nedeniyle doktora başvuran hastalar sıklıkla 15-24 yaş arası erkeklerdir. Sağlık ocağı hekimleri; bu hastaları koyu tenli, kıl oranı fazla ve kilolu kişiler olarak tarif etmektedirler. Günümüzde birinci basamak sağlık kuruluşları, pilonidal sinüslü hastalarla en sık karşılaşılan fakat bu hastaların tedavilerinin en az yapıldığı kurumlardır. Buralarda çalışan hekimler hastalarını genellikle sevk etme eğilimindedirler. Bu kişilerin izlemlerinin birinci basamakta yapılamayacağı inancı yaygındır. Aksine, buralarda hizmet verenlere pilonidal sinusün önlenmesi, tanısı, danışmanlığı, yönetim ve izlemi açısından büyük görevler düşmektedir. Takip muayeneleri, yine birinci basamakta aksatılmaması gereken muayenelerdir. Hastanın operasyon sonrası düzenli pansumanlarını yapmak, hastalığın gidişini gözlemek, tedaviye cevabı saptamak ve yüksek risk gösteren kişileri tespit etmek önemlidir.



Anahtar kelimeler: Pilonidal hastalık, birinci basamak sağlık hizmeti



Abstract



Approach to pilonidal disease in primary care



Pilonidal disease is common in our society, and it is named as .kıl dönmesi. in ordinary spoken language. It is characterized by inflammation of one bristle root and formation of abscess by relation with the other bristle roots. "In USA, it is the cause of almost 75000 patients and a great number of operation." Average treatment period with elective metods is 1.5 day. It is known that this disease is related with occupation (for example it is seen more often in people who is working with computer by sitting or who is driving for a long time). If we think that individuals are going to their primary care doctors initially for their health problems; these doctors have important role in pilonidal disease diagnosis, treatment and results. In primary care, patients who have complaints like swelling, blushing and pain in their sacroiliac region; are mostly men age between 15-24. Doctors working in primary care are describing these patients as dark skin, hairy and obese people. Primary care health organizations are the places where pilonidal sinus patients are mostly encountered; but these patients treatments are rarely made in these areas. There is a belief that these patients can not be treated in primary care. "Contrary; health personel working in these places have an important role on the pilonidal sinus preventation, diagnosis, information and observation." "Follow up examinations are again mustn.t be delayed in primary care." It.s important to dress the patients wound after operation, to watch the illness attentively, to determine the response for treatment and detect the individuals who have

high risk for this disease.



Key words: Pilonidal disease, primary health care

References

  • Anderson AW. Hair extracted from an ulcer. Boston Med. Surg. J.1874; 36-74
  • Warren JM. Abscess containing hair on the nates. Am. J. Med. Sci.1854; 55-113
  • Hodges RM. Pilonidal Sinus. Boston Med. Surg. J. 1880; 103: 456
  • Patey DH and Scharff RW. Pathology of postnatal pilonidal sinus; Its bearing on treatment. Lancet 1946; (2): 484
  • Palmer WH. Pilonidal Disease, A new concept of pathogenesis. Dis. Colon Rectum. 1959; 2 :303
  • Page GH. The entry of hair into apilonidal sinus. Br.J.Surg.1969; (56): 32
  • Pekmezci S. Malignant Dejeneration: an unusual complication of pilonidal sinus disease. Eur. J. Surg. Jun 2001;167(6) 475- 7
  • Kulaylat MN. Multimodality treatment of squamoz cell carsinoma complicating pilonidal disease. Am. Surg.Nov 1996; 62 (11):922- 9
  • Miocinovic M. The prevalance of anaerobic infection in pilonidal sinus of the sacrococcygeal region and its effect on the complications. Acta Med. Croatica 2001; 55 (2) : 87-90
  • Bale PM. Ependymal rests and subcutaneous sacrococcygeal ependymoma. Pathology 1980; 12: 237-43
  • Brihaye J. Rectomeningeal fistula in dysraphic states. Surg. Neurol. 1978; (10): 93-5
  • Holmes LB. Hereditary pilonidal sinus. Jama 1969; (209): 1525-6
  • Clothier PR. The natural history of the postanal pilonidal sinus. Ann. R. Coll. Surg. Engl. 1984; (66): 201-3
  • Price ML. Normal body hair-a review. Clin. Exp. Dermatol. 1985; (10):87-97
  • Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process.Aust. N.Z.J. Surg. 1992; (62):385-389
  • Cubukcu A. The role of obesty on the recurrens of pilonidal sinus disease in patients who were treated by excision and Limberg flap transpozition. Int. J. Colorectal Dis. Jun 2000 15(3): 173-5
  • Bissett IP. The management of patients with pilonidal disease - a comporative study. Aust N.Z.J. Surg.1987; (V57): 939-42
  • Berger A. Pilonidal sinus Ann.1995; Chir. 49(10): 889- 901
  • Armstrong JH. Pilonidal sinus Disease - The conservative approach. Arch Surg. Sep. 1994; 129 (9): 214-7
  • Spivak H. Treatment of chronic pilonidal disease. Dis. Colon Rectum Oct. 1996; 39(10): 1136-9
  • Sondenaa K. Morbidity and short term results in a randomize trial of open compared with closed treatment of chronic pilonidal sinus. Eur. J. Surg. Jun-Jul 1992; 158 (6-7); 351-5
  • Hasse FM. The Dufourmental flap-plasty for treatment of chronic pilonidal sinus Chirurg; Jun. 1998; 69(6): 663-6
  • Da Silva Jh. Pilonidal Cyst:cause and treatment. Dis Colon Rectum. Aug 2000; 43(8): 1146-56
  • Jensen SL. Prognosis after simple incision and drainage for a first episode acute pilonidal abscess. Br. J. Surg. Jan 1988; 75(1): 60-1
Year 2007, Volume: 14 Issue: 3, 48 - 51, 06.05.2009

Abstract

References

  • Anderson AW. Hair extracted from an ulcer. Boston Med. Surg. J.1874; 36-74
  • Warren JM. Abscess containing hair on the nates. Am. J. Med. Sci.1854; 55-113
  • Hodges RM. Pilonidal Sinus. Boston Med. Surg. J. 1880; 103: 456
  • Patey DH and Scharff RW. Pathology of postnatal pilonidal sinus; Its bearing on treatment. Lancet 1946; (2): 484
  • Palmer WH. Pilonidal Disease, A new concept of pathogenesis. Dis. Colon Rectum. 1959; 2 :303
  • Page GH. The entry of hair into apilonidal sinus. Br.J.Surg.1969; (56): 32
  • Pekmezci S. Malignant Dejeneration: an unusual complication of pilonidal sinus disease. Eur. J. Surg. Jun 2001;167(6) 475- 7
  • Kulaylat MN. Multimodality treatment of squamoz cell carsinoma complicating pilonidal disease. Am. Surg.Nov 1996; 62 (11):922- 9
  • Miocinovic M. The prevalance of anaerobic infection in pilonidal sinus of the sacrococcygeal region and its effect on the complications. Acta Med. Croatica 2001; 55 (2) : 87-90
  • Bale PM. Ependymal rests and subcutaneous sacrococcygeal ependymoma. Pathology 1980; 12: 237-43
  • Brihaye J. Rectomeningeal fistula in dysraphic states. Surg. Neurol. 1978; (10): 93-5
  • Holmes LB. Hereditary pilonidal sinus. Jama 1969; (209): 1525-6
  • Clothier PR. The natural history of the postanal pilonidal sinus. Ann. R. Coll. Surg. Engl. 1984; (66): 201-3
  • Price ML. Normal body hair-a review. Clin. Exp. Dermatol. 1985; (10):87-97
  • Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process.Aust. N.Z.J. Surg. 1992; (62):385-389
  • Cubukcu A. The role of obesty on the recurrens of pilonidal sinus disease in patients who were treated by excision and Limberg flap transpozition. Int. J. Colorectal Dis. Jun 2000 15(3): 173-5
  • Bissett IP. The management of patients with pilonidal disease - a comporative study. Aust N.Z.J. Surg.1987; (V57): 939-42
  • Berger A. Pilonidal sinus Ann.1995; Chir. 49(10): 889- 901
  • Armstrong JH. Pilonidal sinus Disease - The conservative approach. Arch Surg. Sep. 1994; 129 (9): 214-7
  • Spivak H. Treatment of chronic pilonidal disease. Dis. Colon Rectum Oct. 1996; 39(10): 1136-9
  • Sondenaa K. Morbidity and short term results in a randomize trial of open compared with closed treatment of chronic pilonidal sinus. Eur. J. Surg. Jun-Jul 1992; 158 (6-7); 351-5
  • Hasse FM. The Dufourmental flap-plasty for treatment of chronic pilonidal sinus Chirurg; Jun. 1998; 69(6): 663-6
  • Da Silva Jh. Pilonidal Cyst:cause and treatment. Dis Colon Rectum. Aug 2000; 43(8): 1146-56
  • Jensen SL. Prognosis after simple incision and drainage for a first episode acute pilonidal abscess. Br. J. Surg. Jan 1988; 75(1): 60-1
There are 24 citations in total.

Details

Primary Language English
Journal Section Reviews
Authors

Kurtuluş Öngel

Ebru Katırcı This is me

Cennet Ak This is me

İsmail Sarıkan This is me

Publication Date May 6, 2009
Submission Date May 6, 2009
Published in Issue Year 2007 Volume: 14 Issue: 3

Cite

Vancouver Öngel K, Katırcı E, Ak C, Sarıkan İ. Birinci basamakta pilonidal hastalığa yaklaşım. Med J SDU. 2009;14(3):48-51.

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