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  3. The Hair in the Sinus: Sharp-Ended Rootless Head Hair Fragments can be Found in Large Amounts in Pilonidal Sinus Nests.
 

The Hair in the Sinus: Sharp-Ended Rootless Head Hair Fragments can be Found in Large Amounts in Pilonidal Sinus Nests.

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BORIS DOI
10.7892/boris.101706
Publisher DOI
10.1007/s00268-017-4093-5
PubMed ID
28639004
Description
PURPOSE

Hair has been identified as the causative agent of Pilonidal Sinus Disease (PSD). Stiffer, dark hair as well as hairiness has been postulated as causative factors. Astonishingly, despite the early clinical significance of this condition (Hodges in Boston Med Surg J 2:485-486, 1880), macroscopic and microscopic examinations of hair inside pilonidal sinus cavities have been scarce. The purpose of this study was to study the morphological aspects of the hair found in PSD in order to determine the origin of the hair.

METHODS

Hair from inside pilonidal sinus cavities was collected intraoperatively from 20 PSD patients. Additionally, occipital, lumbar and intergluteal hair was harvested from the same patients and compared to the hair of volunteer-matched pair patients admitted to the hospital at the same time for non-PSD surgery. Intra- and intergroup variations of hair length were characterized with analysis of variance. Numbers and lengths of pilonidal sinus nest hair were recorded. Hair was examined clinically and with light and scanning electron microscopy using surface enhancing gold and carbon dust coating techniques.

RESULTS

Analysis of 624 pilonidal sinus nest hair samples from 20 independent sinus cavities revealed that hair within pilonidal sinus nests is rootless in 74%. Shorter hair was found inside the pilonidal sinus compared to other sites (length 0.9 ± 0.7 cm p < 0.0001). Furthermore, hair found inside of the sinus was significantly shorter than hair protruding from pores (p < 0.000). Hair samples show razor sharp but no broken or split ends. On electron microscopy, these spiky hair ends resemble cut hair ends. Pilonidal hair nests contained between 1 and over 400 hair fragments.

CONCLUSION

Short hair fragments with rootless sharp cut ends were found within pilonidal sinus cavities. Morphologically, these fragments resemble short cut rather than intact body hair. Since short cut hair, e.g., derived from the head potentially enters the pilonidal cavity more easily than longer hair, the source of these cut hair fragments needs to be eliminated when aiming to prevent Pilonidal Sinus Disease.
Date of Publication
2018-02
Publication Type
Article
Subject(s)
600 - Technology::610 - Medicine & health
Language(s)
en
Contributor(s)
Bosche, Friederike
Lüdi, Markus
Universitätsklinik für Anästhesiologie und Schmerztherapie
van der Zypen, Dominic
Moersdorf, Philipp
Krapohl, Bjoern
Doll, Dietrich
Additional Credits
Universitätsklinik für Anästhesiologie und Schmerztherapie
Series
World journal of surgery
Publisher
Springer
ISSN
0364-2313
Access(Rights)
open.access
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