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CompletedNCT04560049Updated Dec 6, 2024

Phenol and Silver Nitrate Application in Pilonidal Sinus

A Phase 4 interventional study of Silver Nitrate and Phenol in Pilonidal Sinus of Natal Cleft and Pilonidal Sinus Without Abscess, sponsored by Umraniye Education and Research Hospital. Completed at 1 site in Turkey. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-12-06.

Sponsored by Umraniye Education and Research Hospital · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
44
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Pilonidal sinus is a disease that affects the young population. Wound healing is a problem after surgical interventions Especially wound healing brings minimally invasive interventions to the fore. In this study we will administer two types of irritating agent for pilonidal sinus disesase. One of them is phenol and second one is silver nitrate solution. And not routinely used for pilonidal sinus disease. The data about availeble in pubmed and google scholar is limited focused on silver nitrate The goal of the study is to compare the silver nitrate and phenol application

Read the detailed description

Sacrococcygeal pilonidal sinus disease is a chronic subcutaneous tissue inflammation that most commonly affects the male sex between the ages of 20 and 30, characterized by burning, itching and discharge in the internal gluteal cleft. It affects the young working population, short return to work after treatment and early return to daily normal activity is socioeconomically important. Although approximately 15 different surgical techniques have been described in the literature in the treatment of pilonidal sinus, a gold standard approach has not been determined. Since it is seen in the young working population, it is important that the ideal treatment has an easy-to-apply, low cost and fast recovery process. The effectiveness of phenol administration as a minimally invasive procedure has been demonstrated with acceptable complication and success rates in prospective and retrospective studies.

Silver nitrate is a caustic and sclerosing substance that impairs tract integrity, such as phenol. It supports the closure of the sinus tract by cauterizing the granulation and epithelialized tissue throughout the sinus. It also has antimicrobial properties to reduce microbial load throughout the tract. Although the effective use and successful results of silver nitrate in the treatment of perianal fistula have been shown, a prospective study has not been conducted yet on the use of pilonidal sinus.

The main purpose of the study is to compare return to normal daily activity between the two groups. This period will be measured in days from the intervention. Participants will not be offered any restrictions after the intervention, and the period of returning to normal daily activities such as starting work at work or doing the housework will be determined by filling out a two-week daily questionnaire. Secondary goals; quality of life, complaints related to pilonidal sinus (itching, burning, discharge), wound infection, closure of pilonidal sinus mouth, recurrence rate and VAS (visual analog scale) scoring.

02

Conditions studied

  • Pilonidal Sinus of Natal Cleft
  • Pilonidal Sinus Without Abscess

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Keywords

  • Pilonidal Sinus
  • Phenol
  • Silver Nitrate
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age > 18 years old
  • Patients who applied to general surgery outpatient clinic for chronic sacrococcygeal pilonidal sinus
  • Patients with written informed voluntary consent forms.

Exclusion criteria

Exclusion Criteria:

  • BMI > 35 kg/m²
  • Recurrent cases
  • Active abscess formation
  • Patients with hydradenitis suppurativa and skin lesions in the perianal region
  • Patients with accompanying anal fistula, anal conduloma and perianal involvement of Crohn's disease
  • Immunosuppressive patients (HIV +, organ transplantation, patients receiving immunosuppressive therapy)
  • Complicated cases (have more than 3 orifice)
  • Patients with known allergic sensitivity to one of the silver nitrate, phenol, nitrofurazone and prilocaine substances
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
44 participants (actual)

Study arms

  • Experimental
    Phenolisation

    Surgical pit excision and phenolisation of sinus tract

    Drug: Phenol

  • Active comparator
    Silver Nitrate Irrigation

    Surgical pit excision and silver nitrate irrigation of sinus tract

    Drug: Silver Nitrate

Interventions

  • DrugSilver Nitrate

    application of silver nitrate to sinus tract

  • DrugPhenol

    phenolisation of sinus tract

05

What researchers measure

Primary outcomes

  1. Healing of the pilonidal sinus disease

    Closure of pit without pus and soiling on physical examination

    Time frame: 8 week

Secondary outcomes

  1. Post-procedure Quality of life assessment

    The quality of life of the patients will be determined by SF-36 test.

    Time frame: 3rd and 8th week after the procedure

  2. Wound infection

    Wound infection is simply classifed as present or not present. It is considered as present when there was a an odd smelling purulent discharge from the wound.

    Time frame: 3rd and 8th week after the procedure

  3. Visual analog scale as pain assessment

    Pain of the patients will be determined by VAS (visual analog scale). Patients are simply asked to score their pain from 1 to 10, which is typically called visual analog scale in the literature, with higher scores representing more severe pain

    Time frame: 3rd and 8th week after the procedure

06

Study locations

1 site
  • University of Health Sciences Umraniye Education and Research Hospital
    İstanbul, 34764, Turkey
07

References and documents

Publications

  • Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160-4. doi: 10.1136/bmj.305.6846.160. PubMed 1285753 ↗
  • Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hrobjartsson A, Schulz KF, Parulekar WR, Krleza-Jeric K, Laupacis A, Moher D. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013 Jan 8;346:e7586. doi: 10.1136/bmj.e7586. PubMed 23303884 ↗
  • Pronk AA, Smakman N, Furnee EJB. Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial. Tech Coloproctol. 2019 Jul;23(7):665-673. doi: 10.1007/s10151-019-02030-w. Epub 2019 Jul 5. PubMed 31278458 ↗
  • Attaallah W, Tuney D, Gulluoglu BM, Ugurlu MU, Gunal O, Yegen C. Should we consider topical silver nitrate irrigation as a definitive nonsurgical treatment for perianal fistula? Dis Colon Rectum. 2014 Jul;57(7):882-7. doi: 10.1097/DCR.0000000000000143. PubMed 24901690 ↗
  • Kayaalp C, Aydin C. Review of phenol treatment in sacrococcygeal pilonidal disease. Tech Coloproctol. 2009 Sep;13(3):189-93. doi: 10.1007/s10151-009-0519-x. Epub 2009 Aug 5. PubMed 19655223 ↗
  • Emiroglu M, Karaali C, Esin H, Akpinar G, Aydin C. Treatment of pilonidal disease by phenol application. Turk J Surg. 2017 Mar 1;33(1):5-9. doi: 10.5152/UCD.2016.3532. eCollection 2017. PubMed 28589180 ↗
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Registry details

Key details

Study ID
NCT04560049
Lead sponsor
Umraniye Education and Research Hospital
Responsible party
Hanife Seyda Ulgur (Assistant Doctor, Umraniye Education and Research Hospital) — Principal investigator
First posted
Sep 23, 2020
Start date
Jun 3, 2020
Primary completion
Jun 15, 2022
Completion
Jun 15, 2023
Last update
Dec 6, 2024

Study contacts

Hanife Ş Ülgür
principal investigator · University of Health Sciences Umraniye Education and Research Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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