A study on different modalities of treatment for pilonidal sinus

Abstract

Background: Excision with lay open method and excision with primary closure (simple closure, z-plasty, limberg flaps are both radical methods for treating pilonidal sinus. The ideal operation should be simple and should not require a prolonged stay, have low recurrence, failure rate and post-operative complication. Aim& Objective: The main objective of the present study to compared different techniques for treatment of sacrococcygeal pilonidal sinus. Methodology: It was a cross sectional study. The materials for this study was taken from the patient admitted to Owaisi hospital from Jan 2013-Dec 2014 (2yr period) Twenty eight patients with pilonidal sinus who were admitted to Owaisi hospital Results: In the present study, 15 out of 28 cases were treated by excision and lay open method. The mortality was nil, but the recurrence was 1 and 2 failures were noticed (totally 22.6% failure) in terms of morbidity. Patients abstained from work till the wound healed i.e. 44-68 days(average 49.5 days).The remaining 13 cases were operated by excision and primary closure (simple closure, z-plasty, limberg flap method) out of which 8 cases were treated with z-plasty and 2 cases with simple primary closure and 3 cases with limberg flap method. The mortality was nil, the recurrence rate and post-operative complications were nil and all patients returned to work early within 7 days. Conclusion: Finally we concluded that all cases where closure is possible should be treated with different closure techniques (simple closure, z-plasty, limberg flap). Deep gluteal cleft is flattened with z-plasty and limberg flap technique. Hence the suction effect is obliterated. All predisposing factors are countered by flap technique hence flap techniques are ideal for treatment for pilonidal sinus.