A comparative study of wide excision and Z-plasty in the management of pilonidal sinus at tertiary care hospital

Abstract

Background: Treatment of pilonidal disease is challenging to surgeon. Post-operative course is lengthy, painful and patients are often unsatisfied. Several treatment modalities have been tried for pilonidal disease including incision & drainage of abscess, excision with primary closure, excision with open packing, excision with marsupilization and recently flap surgery. The aim of present study was to compare the results of wide excision and Z-plasty technique in management of pilonidal sinus.Materials and Methods: The present study was conducted on 50 cases diagnosed as a case of pilonidal sinus and admitted in department of surgery of Dr. S. N. Medical College Jodhpur. Patients were randomly divided into two groups. In Group A, wide excision was done and Group B wide excision was followed by Z-plasty.Results: Wound infection was present in 32% of Group A and 16% of Group B patients as postoperative early complication. Localized loss of sensation observed in 16% of Group A and 24% of Group B patients. Postoperative pain was present for 36.6±1.22 days in Group A and 14.32±1.83 days in Group B. Total healing of wound was reported in 42.2±2.62 days in Group A and 16.6±1.99 days in Group B. Mean days for return to work was 34.64±2.66 days in Group A and 15.44±1.80 days in Group B.Conclusion: Excision with Z-plasty was better technique in terms of less post-operative complications, less time in healing of wound, and early days for return to work.