Emerging treatments
Fibrin glue
Fibrin glue (composed of fibrinogen and thrombin) causes formation of a fibrin clot within the pilonidal sinus to obliterate the dead space. After curetting the sinus tract to remove hair and debris, fibrin glue is instilled into the sinus facilitating clot formation. It may be considered as monotherapy, or as an adjunct to operative curettage. One systematic reviews reported recurrence rates ranging from 5.6% to 29%.[21] Further high quality studies are needed.[22]
Phenol
Phenol is an effective sclerotic agent with antiseptic and anesthetic properties that is thought to denature the hairs thought to cause pilonidal disease. The procedure consists of debriding the tract, enlarging the cavity slightly, and then instilling crystallized or liquid phenol solution into the pilonidal sinus tracts/cavity. Recurrence rates of 9% have been reported to occur in patients treated with phenol. The use of phenol may be used as monotherapy (may require multiple treatments), or as an adjunct to nonoperative or minimally invasive treatment modalities.[4]
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