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Background The traditional open incision and drainage of a pilonidal abscess is associated with slow healing and delayed return to normal daily activities. The aim of this study is to assess safety, effectiveness, and patient satisfaction of aspiration followed by antibiotics for a pilonidal abscess. Material and methods All patients presenting with an acute pilonidal abscess during the period December 2010 and December 2014 in York Hospital, UK, were treated with bedside aspiration under local anesthetic, followed by oral cefalexin and metronidazole for 7 days. Patients with immunosuppression, diabetes, overlying skin necrosis, and perforation were excluded. Complications of the procedure were prospectively recorded. Long-term outcomes and overall patients' satisfaction were assessed with the use of mailed questionnaires and Visual Analogue Scales (VAS) (0 = not satisfied at all, 10 = very satisfied). Results One hundred sixty-nine patients presented with an acute pilonidal abscess and a total of 100 patients were treated with aspiration and antibiotics. There were 50 women (50%) and the median (interquartile range [IQR]) age of the cohort was 24 (14) years. Eleven patients had a history of a previous pilonidal procedure. Seven patients were treated successfully with a reaspiration. Overall, 10 patients required incision and drainage after a median (IQR) follow-up time of 29 (47) months. Fifty-six patients returned completed questionnaires. The median (IQR) of the VAS for the overall satisfaction of the procedure was 9 (5). Conclusions Aspiration of a pilonidal abscess in selected patients is effective in 83%, and it is associated with high overall satisfaction rates. [ABSTRACT FROM AUTHOR]

Background: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. One case extending down to the base of a subcutaneous meningocele at the sacral level has been reported.Clinical presentation: We report on three cases of closed spinal dysraphism, in which a spinal cord-like tethering structure extended out from the dural cul-de-sac and terminated at a skin-covered meningocele sac in the sacrococcygeal region, which was well delineated in curvilinear coronal reconstructed images of 3D-heavily T2-weighted images (3D-hT2WI). Intraoperative neurophysiology revealed the spinal cord-like tethering structure was nonfunctional, and histopathology showed that it consisted of central nervous system tissue, consistent with RMC. The tethering structure histologically contained a glioneuronal core with an ependymal-like lumen and smooth muscle, which may indicate developmental failure during secondary neurulation.Conclusions: When the RMC extending to a meningocele is demonstrated with the detailed magnet resonance imaging including 3D-hT2WI, decision to cut the cord-like structure for untethering of the nervous tissue should be made under careful intraoperative neurophysiological monitoring. [ABSTRACT FROM AUTHOR]

Objective: In the treatment of pilonidal sinus disease different approaches are used such as conservative treatment and fasciocutaneous rotation flap. The aim of this study was to evaluate the efficacy of "de-epithelialization technique" as a new approach in pilonidal sinus disease treatment. Material and Methods: Forty pilonidal sinus disease patients treated with de-epithelialization method were evaluated retrospectively. Patient age, gender, body mass index, wound healing time, visual analog scale scores, operation times, hospital stay duration, drain removal time, cosmetic satisfaction rates, complications, and recurrence rates were evaluated. Results: The numbers of male and female patients in this study were 39 and 1, respectively. The median age of the patients was 25 years and the mean BMI was 26.6. The mean operating time was 43 min, and all patients were discharged 5 h after the operation. Wound healing time varied from 10 to 20 days. Median follow-up period was 9 months (4-17 months). One patient with high body mass index suffered from partial wound separation. No other complications such as infections and fluid collections (hematoma and seromas) were observed. Maximum cosmetic satisfaction rate was 90% (n=36), and no patient had a recurrence during the follow-up period. Conclusion: "De-epithelialization" may be considered as a complementary and/or alternative approach to other surgical techniques such as primary closure, rhomboid excision, and Limberg flap in the treatment of pilonidal sinus disease, with acceptable cosmesis and recurrence rates. [ABSTRACT FROM AUTHOR]

Sacrococcygeal teratomas are the most common solid tumor in newborn infants. The diagnosis is not difficult in many cases; however, there should be additional information on imaging studies in order to manage those infants properly. Details include histology, morphologic classification, complications such as rupture, bleeding, and mass effects on the adjacent structures. Although imaging features cannot accurately predict the histologic subtypes of the tumors, thorough evaluation of the imaging features can help distinguish malignant tumors from benign tumors. In this article, pathogenesis, histological characteristics, clinical considerations, and morphologic characteristics will be discussed. [ABSTRACT FROM AUTHOR]

Aim: Sacrococcygeal pilonidal disease (SPD) is a chronic and uncommon entity. Extensive, complex and recurrent SPD is less frequent, and diverse treatment alternatives have been described. One of these is excision, followed by reconstruction with the rhomboid flap, as described by Dufourmentel. The aim of the present study was to report the results of a series of patients with extensive, complex or recurrent SPD operated on using Dufourmentel’s technique, in terms of postoperative morbidity (POM) and recurrence. Patients and Methods: The present study was a case series of patients with extensive, complex or recurrent SPD, operated on at the Clínica Mayor and Regional Hospital in Temuco, Chile, between 2000 and 2015, using excision, followed by a reconstruction with the Dufourmentel’s rhomboid flap. The outcome variable was POM measured at 30 days’ postoperatively using the Clavien–Dindo classification. Other variables of interest were surgical time, hospital stay, mortality and recurrence. The minimum follow‐up time was 18 months. Descriptive statistics were used. Results: Ninety‐five patients with extensive, complex or recurrent SPD were operated on in the study period. The median age was 21 years, and 56.8 per cent were female. The median surgical time was 60 min (45–90 min). POM was 13.7 per cent, seroma was 5.3 per cent, wound infection was 2.1 per cent and partial surgical wound dehiscence was 6.3 per cent. Mortality of the series was nil. Median hospital stay, follow up and recurrence were 4 days (3–5), 48 months (18–90 months) and 3.2 per cent, respectively. Conclusion: Dufourmentel’s technique applied to patients with extensive, complex or recurrent SPD was associated with adequate postoperative evolution in terms of POM and recurrence. [ABSTRACT FROM AUTHOR]

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Teratomas are a type of multipotential cell tumor that contain a mixture of multiple germinal layers formed by normal organogenesis and reproductive tissues the incidence of intracranial teratomas is low, approximately 0.5-2.2% of all intracranial tumors. The occurrence of teratomas in the spine is extremely rare. Except for in the sacrococcygeal region, teratomas constitute <0.5% of all intraspinal tumors. According to the literature this is only 8th case of dorsal spinal mature cystic teratoma reported till date. [ABSTRACT FROM AUTHOR]

Sacrococcygeal teratoma (SCT) with intraspinal extension is rare. There is a risk of paraplegia associated with prolonged spinal cord compression. We present the case of an infant with a prenatal diagnosis of an SCT with a large intraspinal component that was causing compression of the lower spinal cord. Ultrasound at 33 weeks showed bilateral lower extremity and foot movement without hydrops or cardiac failure. Multidisciplinary decision was made to administer betamethasone and proceed with Cesarean delivery at 34 weeks. A vigorous live-born female was delivered and a multilevel laminectomy was performed at day of life 4. The pelvic resection was performed at 4 months. Pathology revealed mature teratoma. She had an uncomplicated postoperative course, is ambulatory, continent of stool, and has no evidence of recurrence. We conclude that intraspinal extension of SCT should be evaluated prenatally with ultrasound and fetal MRI. If there is concern for spinal cord compression, early delivery and urgent decompressive laminectomy may diminish the neurologic sequelae of prolonged spinal cord compression. Since these cases are rare, risks of prematurity need to be weighed against the neurologic risks. These infants should be treated with a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that removal of body hair in the sacrococcygeal area prevents recurrence after surgery for sacrococcygeal pilonidal sinus disease (SPSD). The aim of this study was to review the literature regarding the effect of hair depilation on the recurrence rate in patients surgically treated for SPSD.Methods: A systematic search was performed in PubMed, EMBASE, and The Cochrane Library by using synonyms for SPSD. Title, abstract, and full text were screened by two independent reviewers. Data were systematically collected from all included studies by using a standardized data extraction form.Results: The search and selection yielded 14 studies, involving 963 patients. The study design of the included studies was: retrospective cohort (n = 7), prospective cohort (n = 3), randomized controlled trial (n = 2), and case–control (n = 2).The mean length of follow-up was 37.0 (standard error of the mean: 35.0) months. The recurrence rate was 9.3% (34 out of 366 patients) in patients who had laser hair removal, 23.4% (36 out of 154 patients) in those who had razor shaving/cream depilation, and 19.7% (85 out of 431 patients) in those who had no hair removal after surgery for SPSD.Conclusions: This systematic review showed a lower recurrence rate after laser hair removal compared to no hair removal and razor/cream depilation. Due to the small sample size and limited methodological quality of the included studies, a high-quality randomized controlled trial is required. [ABSTRACT FROM AUTHOR]

Background: An inguinoscrotal hernia is defined as "giant" if descending below the midpoint of the inner thigh of a patient in upright position. In developed countries this is a rare entity. In the literature different surgical techniques have been reported so far to achieve a successful treatment.Case Presentation: We present the case of a 63 year-old man suffering from a giant inguinoscrotal hernia, whom we treated using a combined open transabdominal and inguinal approach following an unsuccessful laparoscopic attempt. Meshes were placed in a premuscular position (Lichtenstein's procedure) and in a preperitoneal position. In addition, a reconstruction of the abdominal wall by modified components separation technique was performed. During the early postoperative period no complications were registered. Intensive care treatment was not necessary. The patient was discharged on postoperative day 8 in an excellent condition. Six months after surgery a scrotal hematocele was diagnosed and operatively removed. After a follow-up of 1.5 years neither hernia recurrence, nor chronic groin pain were recorded. The patient reported to be sexually active. His quality of life improved notably. Additionally, a Medline and PubMed database research was performed to create an overall picture of the existing surgical treatment strategies. Included were patients with diagnosis of primary giant inguinoscrotal hernia according to the given definition. Emergency interventions and cases without details of the surgical approach were excluded.Conclusions: Firstly, this report describes a novel, successful surgical treatment of a giant inguinoscrotal hernia without administering preoperative progressive pneumoperitoneum therapy or visceral resection. Secondly, we summarize cases previously reported as a practical guide for possible surgical therapy approaches. [ABSTRACT FROM AUTHOR]

Purpose:In order to prevent postoperative infection and recurrence of sacrococcygeal pilonidal sinus, the authors developed a modified Dufourmentel flap, involving the superior pedicles, and designed a descriptive prospective study to evaluate its efficiency. Methods:Between July 2007 and March 2014, 16 patients with sacrococcygeal pilonidal sinus were treated with an irregular quadrilateral excision and reconstruction by a modified Dufourmentel flap with superior pedicle. The duration of wound healing, presence of wound complications and permanent hypoesthesia, and recurrence rates were recorded and assessed. Results:None of the patients developed flap necrosis or wound infection postoperatively. The duration of wound healing was 7.2 ± 2.9 (range = 6–15) days. Wound dehiscence was demonstrated in only one patient (6.3%). The mean follow-up period was 4 years and 2 months (range = 4 months–8 years and 8 months), whereby no permanent hypoesthesia or recurrence was detected. Conclusion:The modified Dufourmentel flap with superior pedicle can be safely used as a treatment of sacrococcygeal pilonidal sinus, with excellent results. [ABSTRACT FROM PUBLISHER]

Objectives Recent clinical reports showed excellent results when the lay open method was used for the treatment of chronic sacrococcygeal pilonidal sinus, despite keeping the wound open for a considerable time which increases the risk of infection, delayed closure, and recurrence. In this study, we aim to analyze the factors influencing the outcome of the laid open sacrococcygeal pilonidal wound regarding wound infection, complete wound closure, and recurrence. Methods A prospective cohort study of 472 patients with chronic sacrococcygeal pilonidal sinus who had the lay open procedure between January 2000 and December 2012 was done. 326 were male and 146 were female. Lay open was performed to all patients. Postoperative care and follow-up methods were similar in all patients. Preoperative, intraoperative, and postoperative factors affecting the outcome were analyzed. Results The mean age was 27.6 years. Male gender, smoking, BMI ≥ 30 kg/m 2 , diabetes mellitus, the sinus number, wound depth of more than 3 cm, packing the wound, the cleaning material for wound irrigation, regular postoperative shaving of hair around the wound, postoperative complications mainly pus discharge from the wound, and poor postoperative body hygiene were the factors statistically found to represent a significant difference in association with longer wound healing time (P ≤ 0.01). The recurrence rate was 0% after four years of follow-up. Conclusion We concluded that many factors could affect the outcome of the laid open wound of the chronic sacrococcygeal pilonidal sinus. For the best outcome, careful consideration of these factors could help achieve an excellent result. [ABSTRACT FROM AUTHOR]

Background Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. Methods A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included. The T2 sagittal image that provided the best view of the sacrococcygeal membrane and the dural sac was chosen. We used Picture Achieving and Communication System (Centricity® PACS, GE Healthcare Co.) to measure the distance between the sacrococcygeal ligament and the dural sac, the length of the sacrococcygeal ligament, and the maximum depth of the caudal space. Results There were strong correlations between age, weight, height, and BSA, and the distance between the sacrococcygeal ligament and dural sac, as well as the length of the sacrococcygeal ligament. Based on these findings, a simple formula to calculate the distance between the sacrococcygeal ligament and dural sac was developed: 25 × BSA (mm). Conclusion This simple formula can accurately calculate the safe depth of the caudal epidural space to prevent unintended dural puncture during caudal block in children. However, further clinical studies based on this formula are needed to substantiate its utility. [ABSTRACT FROM AUTHOR]

Holt-Oram syndrome (HOS) is characterized by upper-limb defects and congenital heart malformation, and its prevalence is very rarely. Mature cystic teratoma is the most common tumor seen in neonates and its most common location is sacrococcygeal region. Diagnosis of a sacrococcygealteratoma should be confirmed by pathology. Surgical resection is the mainstay therapeutic approach of this tumor. Some malformations such as genitourinary system, musculoskeletal anomalies, neural defects, cardiovascular anomalies, and pulmonary disorders associated with this tumor have been reported. Herein, we reported a male neonate diagnosed with HOS associated with sacrococcygealteratoma. To our knowledge, it has been not reported a case with HOS associated with sacrococcygealteratoma. Patients with sacrococcygealteratomas (SCTs) may have multiple and extreme congenital abnormalities; therefore, patients with SCTs should be carefully evaluated clinically, laboratory, and radiologically and it should be also considered that HOS may accompany them., Competing Interests: None declared., (© Copyright 2023 by The Medical Bulletin of Sisli Etfal Hospital.)

Rationale: Urinary dysfunction triggered by varicella-zoster virus (VZV) attacking the nervous system seriously affects the quality of life of patients and may even cause irreversible damage to the urinary system. This a 62-year-old man with acute urinary retention triggered by VZV, who was cured after acupuncture treatment. The rational application of acupuncture therapy to promote the recovery of bladder contraction function can effectively relieve the symptoms of dysuria, shorten the course of the disease., Patient Concerns: Symptoms included dysuria and distension of the bladder area secondary to postherpetic herpes zoster, with significant pressure and pain in his lower abdomen, accompanied by cutaneous herpes distributed over the sacral region., Diagnoses: The case was diagnosed as acute urinary retention (Neurogenic Bladder). Ancillary tests include urodynamic examination, Doppler ultrasound, urodynamic tests are the preferred diagnostic method and suggest: no contraction of the detrusor muscle is seen during voiding, and voiding occurs in an The absence of abdominal pressure-assisted micturition and repeated attempts to pass urine suggests detrusor weakness; residual urine suggests a severe bladder emptying disorder. Doppler ultrasound suggested overfilling of the bladder, and 1153 mL of residual urine was seen in the bladder after voiding., Interventions: The patient developed sacral herpes and dysuria and was treated with oral antiviral drugs on the 12th day of illness. But his urinary difficulty did not improve but gradually worsened, resulting in acute urinary retention, and he then turned to the acupuncture treatment, innovative approach combined the mechanism of action of sacral neuromodulation with traditional Chinese medicine theory., Outcomes: The duration of acupuncture treatment totaled 12 weeks; he was able to urinate on her own and her symptoms completely disappeared. No other adverse and unintended events occurred during treatment., Lessons: This study demonstrates that acupuncture is safe and effective in the treatment of acute urinary retention caused by VZV, which is worth recommending as a conservative treatment. Moreover, we found that the early intervention and full-term treatment with acupuncture is particularly important, provided that the right key acupoints are selected., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

This article describes a posterior trans-sacral approach to the presacral space. This is an important technique in contemporary colorectal surgical practice for resection of presacral tumours, and less commonly to allow access for rectal sleeve advancement, segmental resection of the lower rectum (rarely indicated in the era of total mesorectal excision and trans-anal techniques), drainage of supralevator sepsis and resection of extensive ischiorectal fossa tumours., (© 2023 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

Background: With increasing global interest in sleep hygiene, sleep ergonomics is an area that has been largely understudied. During sleep individuals turn over during the night to restore blood flow in occluded blood vessels, indicating that control of local tissue pressure may play a role in improving sleep comfort. This study investigates the influence of mattress stiffness on tissue compressive stresses during supine lying., Methods: A subject-specific 3D finite element (FE) model of the pelvis area has been developed to simulate supine lying on substrates of varying firmness. Constitutive parameters for the adipose-skin tissue and muscle-organ tissue were calibrated using a novel application of the inverse finite element method., Findings: The compressive stress was consistently greatest in the muscle interfacing the sacrum at 18.5 kPa on the soft foam, and 30.9 kPa on the firm foam. From soft to firm, the compressive stress increased by 67% at the sacrum, 20% at the ischium, 42% at the lesser trochanter, and 50% at the skin., Interpretation: The non-linearity of the foam substrate had a pressure distributing effect, relieving the peak compressive stresses at the sacrum, indicating that it may be possible to design arrays of foam substrates that can provide most efficient pressure relief., Competing Interests: Declaration of Competing Interest None, (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Anterior dislocation of the coccyx is rare, but it can occur due to trauma. Conservative treatment is usually performed. However, dislocation reduction may be required to control severe pain in the acute phase or to prevent chronic complications. If manual reduction fails, open reduction is required. The extent of the incision and the method used to maintain the reduction should be considered during open reduction. A 56-year-old male patient experienced a dislocation of the sacrococcygeal joint after falling backwards. Despite conservative treatment, the patient complained of persistent pain during sitting and when using the bathroom. A manual reduction was attempted but failed. We performed joystick reduction via minimal incision and maintained the reduction using a one-strand trans-osseous suture passing through the skin. The patient was advised to use a soft cushion when sitting or lying down for four weeks after surgery. The supine position was not restricted. The patient's symptoms significantly improved after surgery. At the 6-month follow-up, the sacrococcygeal joint showed good alignment and no surgical complications occurred. During the treatment of sacrococcygeal dislocation, the rapid alleviation of acute pain and minimizing potential complications are key points. If open reduction is needed, the minimally invasive reduction technique with a one-strand trans-osseous suture may offer patient satisfaction and a good surgical outcome.

Background: This retrospective study aimed to demonstrate surgical operative approach of total pelvic exenteration combined with sacral resection with rectal cancer and elucidate the relationships between the level of sacral resection and short-term outcomes., Methods: Twenty cases were selected. Data regarding sex, age, body mass index, neoadjuvant therapy, location of sacral resection ("Upper" or "Lower" relative to the level between the 3rd and 4th sacral segment), operative time, bleeding, and curability (R0/R1) were collected and compared to determine their association with complications exhibiting a Clavien-Dindo grade III., Results: The complication rate was significantly higher for recurrent cancers (n = 10, 76.9%) than for primary cancers (n = 1, 14.3%) ( P = .007), and for "Upper" resection (n = 8, 72.7%) than for "Lower" resection (n = 3, 33.3%) ( P = .078). Significant differences were observed when complication rates for "Lower" and primary cancer resection (n = 3, .0%) were compared between "Upper" and recurrent cancers (n = 8, 100.0%) ( P = .007)., Conclusion: In patients with recurrent rectal cancer, "Upper" sacral resection during total pelvic exenteration is associated with a high complication rate, highlighting the need for careful monitoring., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article. Availability of Data and MaterialsThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Head of bed elevation is used to manage some medical and surgical conditions however this may increase a patient's risk of sacral pressure injuries. Novel point-of-care technologies that measure subepidermal moisture can identify changes in localised subepidermal oedema and potential pressure injury risk. This prospective exploratory study investigated variations in sacral subepidermal oedema in healthy adults during 120-min of 60° head of bed elevation. Sacral subepidermal oedema was measured at 20-min intervals using the Provisio® subepidermal moisture scanner. Descriptive analysis, one-way repeated measures analysis of variance and an independent t-test were conducted. Slightly more male volunteers (n = 11; 55%) were recruited and the sample mean age was 39.3 years (SD 14.7) with an average body mass index of 25.8 (SD 4.3). Little variation in the mean sacral subepidermal moisture of healthy adults was observed. There was a statistically significant difference in the mean sacral subepidermal moisture measurements between males and females (Mean difference 0.18; 95% confidence intervals: 0.02 to 0.35; P = .03). Healthy adults can tolerate prolonged 60° head of bed elevation without developing increased subepidermal sacral oedema. This warrants further investigation in other populations, in various positions and over different time periods., (© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Avulsion injuries of the pelvis are common sports-related findings in skeletally immature adolescent patients. They usually present as an avulsion of the unfused apophysis, resulting from forced muscular contraction during typical athletic movements or from chronic traction injuries. Acute apophyseal avulsion injuries are usually easily detected with radiography. Occasionally, advanced imaging such as ultrasound or magnetic resonance imaging is required in order to detect or fully assess the extent of injury. Chronic injuries can mimic aggressive entities, such as neoplasms and may thus cause difficulties in differential diagnosis. Profound knowledge of typical locations of apophyseal tendon attachment sites at the osseous pelvis and correct interpretation of imaging findings can facilitate accurate diagnosis. This article discusses the clinical and radiological findings of pelvic apophyseal avulsion injuries in pediatric patients and highlights potential complications and differential diagnoses., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

There are a range of anterior-based approaches to address flexible adult spinal deformity from the thoracic spine to the sacrum, with each approach offering access to a range of vertebral levels. It includes the transperitoneal (L5-S1), paramedian anterior retroperitoneal (L3-S1), oblique retroperitoneal (L1-2 to L5-S1), the thoracolumbar transdiaphragmatic approach (T9-10 to L4-5), and thoracotomy approach (T4-T12). The lumbar and lumbosacral spine is especially favorable for anterior-based approaches given the relative mobility of the peritoneal organs and position of the vasculature., (Copyright © 2023 Elsevier Inc. All rights reserved.)

We assess the theoretical feasibility of percutaneous posterior sacral foramen (pSF) needle puncture of the sacral dural sac (DS) by studying the three-dimensional imaging anatomy of pSFs relative to the sacral canal (SC). On CT images of 40 healthy subjects, we retrospectively studied sacral alae passageways from SC to pSFs in all three planes to determine if an imaginary spinal needle could theoretically traverse S1 or S2 pSFs in a straight path toward DS. If not straight, we measured multiplane angulations and morphometrics of this route. We found no straight connections between S1 or S2 pSFs and SC. Instead, there were bilateral spatially complex dorsoventral M-shaped "foraminal conduits" (FCs; common, ventral, and dorsal) from SC to anterior SFs and pSFs that would prevent percutaneous straight needle puncture of the DS. This detailed knowledge of the sacral FCs will be useful for accurate imaging interpretation and interventional procedures on the sacrum., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Support surfaces are the most important pressure ulcer/injury prevention technology available to clinicians for protecting their at-risk patients. A hybrid support surface marries the benefits of reactive and active support surfaces, by using high-quality foam material inside inflatable air cells. When used in its "static mode", it is a constant low air pressure mattress which delivers pressure redistribution in response to patient bodyweight and movements, by maximising the immersion and envelopment performance of the support surface. When used in its powered "dynamic mode", this system further delivers alternating pressure care via the connected foam and air cells. Modes of action of hybrid support surfaces were never studied quantitatively before, excluding through the limited scope of interface pressure mapping. In this work, we developed a novel computational modelling framework and simulations to visualise and quantify the state of soft tissue loading at the buttocks of a supine patient positioned on a hybrid support surface, in both the static and dynamic modes. We found that the dynamic mode effectively shifts deep concentrated soft tissue loading from under the sacral bone (towards the sacral promontory) to the tip of the sacrum (coccyx) and vice versa, and thereby, generates a deep tissue offloading effect., (© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Cervical teratomas are very rare tumors, accounting for approximately 3%-5% of all pediatric teratomas with predominance in females. Most common site of cervical teratoma is sacrococcygeal region and occurrence in cervical region is a rare presentation. We present a case of cervical teratoma in a 4-month-old male infant presenting as neck mass mimicking as neuroblastoma with differentiation on fine-needle aspiration. The final diagnosis of mature teratoma was made on histopathological examination. [ABSTRACT FROM AUTHOR]

Background: Sacrococcygeal pilonidal sinus is a common morbid disease in young adult patients with high recurrence rate. There are several surgical procedures for managing pilonidal sinus. The present study aims to evaluate the efficacy of limberg flap reconstruction surgery for the management of sacrococcygeal pilonidal sinus. Methods: A prospective study was conducted over a period of more than two years from January 2017 to June 2019. A total of 21 patients were included in this study. All patients underwent Limberg flap reconstruction. Data collected in data collection sheet regarding demographic data, post operative complications and analyzed in tabulated form. Results: Total 21 patients were included in our study. Age ranged from 20-50 years. Male were 18(85.71%) and female were 3(14.29%). Post operative complications were seroma 2(9.52%), wound infection 1(4.76%). But no flap necrosis and recurrence had occurred. Conclusion: Limberg flap for reconstruction of the defect after excision of sacroccoccygeal pilonidal sinus is an effective and safe technique with low complication rate. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical efficacy of bilateral superior and inferior gluteal artery perforator flaps in the repair of large sacrococcygeal pressure ulcers. Methods A local rotation flap was designed, pedicled with the bilateral superior and inferior gluteal artery perforator. The area of the flaps was from 30 cm × 18 cm to 45 cm × 25 cm. For 8 patients with large sacrococcygeal pressure ulcers (15 cm × 9 cm to 18 cm × 12 cm), the wound was covered by flaps. Results All flaps survived, of which 6 cases were healed in the first stage and 2 cases in which healing was delayed. All patients were followed up from 1 to 3 months. There was no recurrence of pressure ulcers, the elasticity of the flaps was good, and bilateral buttocks were symmetrical. Conclusion The application of bilateral superior and inferior gluteal artery perforator flaps was a simple and feasible method in the repair of large sacrococcygeal pressure ulcers. [ABSTRACT FROM AUTHOR]