Comparative Study on Short-Term Outcome in Patients Undergoing Pilonidal Sinus Surgery in Tertiary Care

Abstract

ABSTRACT Background: Pilonidal sinus is a disease that affects young men commonly arising from the hair follicles of the sacrococcygeal area. At present, there is no standardized surgical management available for chronic pilonidal sinus. The purpose of this study is to evaluate wound healing and short-term outcomes in pilonidal sinus patients undergoing modified Limberg flap surgery and lay open for secondary healing after excision in a tertiary care hospital. Patients and Methods: This is a nonrandomized comparative observational study performed at Apollo Hospitals, Chennai, during January 2021 to August 2021. Group A included 25 participants who opted off-midline primary closure using modified Limberg rhomboid flap procedure. Group B included 25 participants who underwent excision of pilonidal sinus and laying the wound open for secondary healing. All patients, in both groups, were seen on the 3rd, 5th, 7th, 15th, and 30th post-operative day. They were followed until complete wound healing. Results: The study showed that the modified Limberg flap closure group had a shorter period of complete wound healing in comparison to the excision and lay-open group but at a cost of prolonged duration of hospitalization. This study shows the significant difference in the period to return to daily activity between Group A and Group B. Postoperative wound complications such as infection and recurrence were seen in Group A. Conclusions: Conventional wide excision of pilonidal sinus and laying it open for secondary healing is advisable in pilonidal sinus disease and be performed as a day-case surgery. For the success of modified Limberg flap closure, prone nursing is recommended.