Kyste pilonidal et traitement par laser d`épilation

Transcription

Kyste pilonidal et traitement par laser d'épilation
Écrit par Administrator
Mardi, 28 Juillet 2009 11:33 -

Certains patients présentent des infections dans le triangle englobant la zone du sacrum et le
pli interfessier. Certaines de ces infections ont pour origine la présence anormale de poils ou
simplement leur pousse anormale sous peau. Cette zone étant particulièrement exposée à la
prolifération de germes fécaux, ces patients développent fréquemment des infections ou abcès
conduisant généralement à des interventions chirurgicales tendant de repérer la cause pour la
supprimer. Le suivi post chirurgie comporte des soins de pansement.
La récupération de la
position assise peut nécessiter quelques jours à cause de la douleur ou simplement de la
cicatrisation de la zone opérée. Malheureusement, ces infections sont récidivantes.
Il a été démontré dans 2 études scientifiques en 2005 que le traitement laser (alexandrite, diode
ou IPL) des kytes pilonidal permet d’améliorer et de baisser le taux de récidive. IL faut compter,
suivant les cas, entre 3 et une douzaine de traitements pour obtenir une amélioration ou un
traitement complet des récidives. Le poils traité devient généralement très fin au bout de 2 à 3
séances, ce qui, dans la majorité des cas, est suffisant pour régler le problème
d’inflammation/surinfection. Des études ont également démontré que les soins lasers pendant
la phase de cicatrisation permettre de raccourcir cette phase.
Successful treatment of recurrent pilonidal sinus with laser epilation.
PMID: 15996432 [PubMed - indexed for MEDLINE]
Dermatol Surg. 2005 Jun;31(6):726-8.Click here to read
1/8
Landa N, Aller O, Landa-Gundin N, Torrontegui J, Azpiazu JL.
Dermitek Clinic of Laser, Dermatology and Aesthetic Surgery, Bilbao, Basque Country, Spain.
[email protected]
http://www.dermitek.com/noticias/PILONIDALSINUS.pdf
BACKGROUND: Pilonidal disease is a chronic disease of the natal cleft. Recurrent follicular
infection is the causative factor. Surgical treatment has a significant failure rate, and recurrence
is common. Laser removal of hair in the natal cleft could be an alternative to surgery.
OBJECTIVE: To determine the effectiveness of laser hair removal in the natal cleft on pilonidal
disease. METHODS: Six young men with recurrent pilonidal disease were treated with laser
epilation in our clinic from 2000 to 2003. Most patients had a history of one or more surgical
treatments in the area, and all patients had suffered recurrent folliculitis for years. An
alexandrite laser was mostly used, although, occasionally, an intense pulsed light device was
used. The number of epilation treatments ranged from 3 to 11, performed at 6- to 8-week
intervals. RESULTS: All patients experienced progressive resolution of the folliculitis with the
laser epilation treatments. No more surgical treatments have been needed. The treatments
were simple and quick, and there were no complications. CONCLUSION: Laser epilation of the
natal cleft should be considered a first choice treatment for recurrent pilonidal disease.
Preventive laser epilation of the natal cleft in patients with recurrent folliculitis could avoid future
surgery.
Treatment of pilonidal disease with laser epilation.
Schulze SM, Patel N, Hertzog D, Fares LG 2nd.
Am Surg. 2006 Jun;72(6):534-7
2/8
Seton Hall University School of Graduate Medical Education, General Surgical Program at St
Francis Medical Center, Trenton, New Jersey, USA.
Pilonidal disease is a debilitating, chronic disease of the natal cleft. It mainly involves the
sacrococcygeal region and the presentation varies from asymptomatic pits to painful draining
abscesses. Treatment options vary from observation to wide excision. Unfortunately, surgical
treatment often results in recurrence. The etiologic agent remains in question, as does the
optimal treatment. Our objective was to assess the efficacy of laser epilation as an adjunctive
therapy to surgical excision of the pilonidal sinus. Eighteen men and five women were treated
with laser epilation in our office from 2001 to 2004. All patients had experienced recurrent
folliculitis and had undergone some form of drainage procedure or prior excision. After surgical
excision of the affected area, a Vasculite Plus laser was used for the epilation treatments. Each
session involved 9 to 12 treatments and the patients underwent an average of two sessions. All
19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for
further surgical procedures. During treatment, six of the men and one of the women
experienced a superficial wound dehiscence. All healed with local wound care and continued
laser treatments. Laser epilation is an effective adjunctive therapy for the treatment of pilonidal
disease. Although not curative in and of itself, the removal of hair allows better healing and
decreases the chance of recurrence by removal of a significant etiology of pilonidal disease.
Laser epilation is a safe and effective therapy for teenagers with pilonidal disease.
J Pediatr Surg. 2009 Jan;44(1):282-5.
3/8
Lukish JR, Kindelan T, Marmon LM, Pennington M, Norwood C.
Department of General Surgery, Uniformed Services University of the Health Sciences,
Bethesda, MD 20814, USA. [email protected]
Pilonidal disease (PD) is a frustrating condition because of a recurrence rate as high as 30%.
Hair insertion is the essential cause of the disease. Therefore, hair removal with shaving is a
part of many postoperative regimens. These methods are resource intensive and adversely
impact the life-style of both patient and family. Therefore, we investigated the use of laser
epilation (LE) of the intergluteal hair in adolescents with PD as a method of permanent hair
removal. METHODS: A retrospective review of all patients with PD who underwent LE from
2003 to 2006 at the National Naval Medical Center, Bethesda, Md, and Walter Reed Army
Medical Center, Washington, DC, was performed. Laser epilation of the intergluteal hair was
carried out with a 1064 nm Nd:YAG laser (Coolglide Vantage, Altus/Cutera, Brisbane, Calif) at
a standard fluence (joule/square centimeter), pulse duration, and repetition rate based on skin
phototype. The patients were observed for hair regrowth and recurrence. RESULTS:
Twenty-eight teenagers (17 males, 11 females; mean age, 17.2 +/- 1.4 years) underwent LE.
Eight patients presented with abscess and were managed by incision and drainage followed by
excision and open wound management, 17 patients presented with a cyst or sinus and
underwent excision and primary closure, and 3 patients with asymptomatic sinus were managed
nonoperatively. Laser epilation was performed after complete wound healing or immediately in
those patients with asymptomatic sinus disease. Laser epilation was well tolerated and without
complication in all patients. Intergluteal hair was completely removed in all patients. Patients
required an average of 5 +/- 2 LE therapy sessions for hair removal. All patients underwent at
least 3 LE sessions (range, 3 to 7 sessions) at 4-week intervals. One female developed a
recurrence. The mean follow-up for the group was 24.2 +/- 9.9 months. CONCLUSIONS: Laser
epilation is a safe method to remove intergluteal hair in teenagers with PD. This technique is an
effective adjunctive therapy for the treatment of PD that may reduce recurrence.
Laser depilation of the natal cleft--an aid to healing the pilonidal sinus.
Ann R Coll Surg Engl. 2002 Jan;84(1):29-32.
4/8
Odili J, Gault D.
RAFT Institute of Plastic Surgery, Mount Vernon Hospital, Northwood, UK. [email protected]
BACKGROUND: Pilonidal disease is common. Excessive hair growth in the natal cleft is
thought to be a factor in initiating these sinuses. It is chronic and intermittent in nature and
treatment can be difficult. Hair removal by shaving or use of creams is often advised as a
compliment to surgical treatments. However, access to the natal cleft can be difficult. Laser
removal of hair in the natal cleft is considered as an aid to healing the pilonidal sinus.
PATIENTS AND METHODS: Over a 5-year period, 14 patients with recurrent pilonidal disease
were treated in our unit with laser depilation. They were all contacted by postal questionnaire,
and those with ongoing disease were asked to return to the clinic for evaluation and possible
further treatment. RESULTS: All patients returned the postal questionnaire. Of the 14 patients, 4
had on-going disease and received further depilation with the Alexandrite laser. All are now
healed with no reported complications. All patients found the procedure painful and received
local anaesthetic. CONCLUSIONS: Laser depilation in the natal cleft is by no means a cure for
pilonidal disease. Removal of hair by this method represents an alternative and effective
method of hair removal and, although long lasting, is only temporary. However, it allows the
sinuses to heal rapidly. It is relatively safe, and simple to teach, with few complications. It should
thus be considered as an aid to healing the problem pilonidal sinus.
Pilonidal sinus disease treated by depilation using an 800 nm diode laser and review of
the literature.
Dermatol Surg. 2005 May;31(5):587-91.
5/8
Benedetto AV, Lewis AT.
Dermatologic SurgiCenter, Philadelphia, Pennsylvania, USA. [email protected]
BACKGROUND: Pilonidal sinus disease is a debilitating, disfiguring chronic ailment that is often
resistant to therapy. Its etiology and treatment remain in question. OBJECTIVE: To assess the
efficacy of an 800 nm diode laser in the treatment of recalcitrant pilonidal sinus disease.
METHODS: Two patients with recalcitrant pilonidal sinus disease were treated in the lower
back, buttocks, and perigluteal cleft area with an 800 nm diode laser with a spot size of 9 x 9
mm, fluences of 30 to 48 J/cm2, and pulse widths of 15 to 24 milliseconds. RESULTS:
Long-term relief of pilonidal sinus disease was produced with as few as two treatments 2
months apart to as many as six treatments over a 2-year period. With each successive
treatment, fewer pulses were needed and the interval between treatments increased.
CONCLUSION: The 800 nm diode laser may be an effective tool in the treatment of pilonidal
sinus disease. By eliminating the source of hair and hair fragments that course along the
surface of the lower back and buttocks, interruption of the etiologic source for pilonidal sinus
disease can be accomplished.
Recurrent pilonidal sinus treated with epilation using a ruby laser.
J Cosmet Laser Ther. 2002 Jun;4(2):45-7.Click here to read Links
Lavelle M, Jafri Z, Town G.
6/8
Princess Royal Hospital, Haywards Heath, UK.
BACKGROUND: Surgical treatment of pilonidal sinus disease of the natal cleft has a significant
failure rate. Reported here is the case of a 33-year-old man who first presented at the age of 18
with a pilonidal sinus. METHOD: The patient's scar was treated with a ruby laser using a pulse
length of 2 ms and energy densities of 6.0-7.2 J/cm(2). Treatment was performed five times at
6-week intervals. RESULT: The sinus healed and has not recurred to date, 6 months after the
last treatment. CONCLUSION: It is felt that there may be a future for this treatment, either as
primary treatment or as an adjunct to surgery in refractive cases. It could also be useful in
preventing the growth of hairs into wounds that have been left open and allowed to granulate.
Laser depilation and hygiene: preventing recurrent pilonidal sinus disease.
J Plast Reconstr Aesthet Surg. 2008 Sep;61(9):1069-72. Epub 2007 Jul 30.
Conroy FJ, Kandamany N, Mahaffey PJ.
University College Hospital, Galway, Ireland.
BACKGROUND: Pilonidal sinus disease of the natal cleft is a painful and debilitating condition
which often recurs despite multiple surgical undertakings. We describe the long pulsed
alexandrite laser for hair depilation and the role of personal hygiene, which is often overlooked
when treating this disease, as an adjunct to preventing recurrent pilonidal sinus disease.
7/8
METHODS: A review of 14 patients who underwent laser hair depilation in the natal cleft
following pilonidal sinus surgery. The majority of patients had recurrent disease and had
undergone numerous surgical procedures (range 1-5, mean 2.07) All patients were given advice
regarding meticulous personal hygiene at the time of consultation. RESULTS: 12 patients
received the full course of treatment (three treatments, 6-weekly) followed by 'top-up' treatments
as required (mean number of treatments 3.9). None of the patients developed recurrent disease
at 1-year follow up and, to date, none have required further surgery. CONCLUSION: Laser hair
depilation is a useful adjunct in preventing the recurrence of pilonidal sinus disease and should
be offered routinely to all patients. This coupled with patient education regarding personal
hygiene reduces the risk of developing recurrent pilonidal sinus disease.
8/8

Kyste pilonidal et traitement par laser d`épilation

Transcription

Documents pareils

The Evolving Field of Laser Surgery

Crème Vaniqa, des précisions - Par medecin

Peut-on utiliser la crème Vaniqa sur les seins en parallèle d`une

Excellent outlook for your eyes

50% off Photorejuvenation/ IPL

Fractional Treatment of Aging Skin with an

Natural tetrapeptide and analogues agent for stimulating hair growth

isros 2009 - CCT

DERIVATION OF OPTICAL AND LASER SIGHT OFFSETS by: Philip

Obituaries - The Natal Society Foundation

Male dispersal patterns in white-faced capuchins, Cebus capucinus

A revised classification of the cleft lip and palate