Using phenol for treating pilonidal sinus: a systematic review and meta-analysis

Abstract

Pilonidal sinus is an acquired disease that affects the natal cleft. Phenolization is a common conservative treatment approach due to its robust antiseptic effects. The aim of this study is to systematically review and evaluate the quality of the controlled clinical trials that investigated the effectiveness of phenol, as a standalone or an adjunct treatment, compared to surgical intervention in reducing sinus recurrence rate and hospitalization period. Four electronic databases were searched (MEDLINE (PubMed), Scopus, Web of Science, Cochrane) from inception to October 2018. The retrieved studies were screened by two independent reviewers. The risk of bias was assessed using the Jadad tool. Meta-analysis was conducted to examine recurrence rate and hospital stay using random effect model while I2 test was used to assess heterogeneity. Five studies were eligible for qualitative and quantitative assessment; 228 patients were treated with phenolization (45.6%) and 272 patients were treated with surgery (54.4%). Phenolization reduces the Likelihood of hospital stay after the procedure by 96–100% compared to surgery. For recurrence rate, the pooled analysis showed no significant difference between phenol and surgery treatment. However, 33.33% of cases did not recur after multi applications of crystallized phenol. Phenolization of patients with pilonidal sinuses is significantly associated with less hospitalization compared to surgical intervention. However, both approaches have a comparable recurrence rate and complications.

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