Evaluation of the risk factors of pilonidal sinus: a single center experience.

BACKGROUND/AIMS: We aimed to evaluate which factors, if prevented, could facilitate a decrease in the rate of pilonidal sinus. MATERIALS AND METHODS: From November 2008 to 2010, all patients referred to the surgery clinic were examined by the general surgery attending physician. Patients with a diagnosis of pilonidal sinus were considered as the trial group. The control group included healthy persons who accompanied the patients to the clinic. Both groups completed a questionnaire form, which included age, sex, occupation, weight, height, number of baths taken per week, mean duration of sitting and driving, and family history of pilonidal sinus. The Statistical Package for the Social Sciences software was used to analyze the data. RESULTS: Positive family history was seen in 71.7% of patients compared to 23.2% of the control group. 70.7% of patients had body mass index >25, whereas only 12.9% of the control group were overweight. P value was significant for family history and body mass index >25. Long duration of sitting was seen in 66.7% of patients vs. 22.8% of the control group (p: 0.002). Long duration of driving was reported in 70.7% of the patient group compared to 24.8% of the control group (p: 0.001). Irregular hygiene of the sacrococcygeal region was noted in 74.7% of the patient group, while 40.6% of the control group took baths less than three times per week (p value was significant). Pilonidal sinus was seen in 39.4% of drivers in the patient group and in 23.8% of the control group (p: 0.012). P value was not significant between students in the patient and control groups (30.3% vs. 23.8%, respectively). CONCLUSIONS: Weight loss and regular hygiene, especially in patients with long durations of sitting and/or driving, are the suggested preventative measures to decrease the risk of disease.

Comparison of conservative management and laparotomy in the management of stable patients with abdominal stab wound.

INTRODUCTION: The management of the hemodynamically stable patients with penetrating abdominal stab wounds is a problematic issue among trauma surgeons. METHODS: In a retrospective study, we analyzed stable patients with anterior abdominal stab wound from August 2009 to 2010. The patients who were hemodynamically unstable or had developed peritonitis were excluded. In our center, the patients are treated through conservative or operative management depending on the protocol of management of the stable penetrating abdominal stab wound in our center. We compared the effectiveness, mean duration of hospital admission, and the time of starting diet in 2 groups. RESULTS: There were 99 cases including 47 patients in the conservative group and 52 in the laparotomy group. The laparotomy was negative in 73% and positive in 27% of the patients. In the conservative group, all the patients remained asymptomatic and stable except for 6 patients who needed subsequent laparotomy. The maximum period between admission and delayed laparotomy in these 6 patients was 17 hours. The mean length of hospital stay and the time of starting diet were 70.4 vs 43 hours and 42.3 vs 30.6 hours in the operative group and conservative group, respectively. P < .05 was considered significant. CONCLUSION: Our study showed that conservative management of asymptomatic and stable patients with anterior abdominal stab wound with physical examination can decrease the rate of normal laparotomy and the length of hospitalization and help to start diet earlier. This study made this hypothesis that after 17 hours of observation, diet can be started for the stable asymptomatic patients.