Abstract
Background and Aims: Pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort for the patient. Although there are various therapeutic modalities to manage these patients, Controversy for choosing the best surgical technique in order to decrease the recurrence rate, patient discomfort, and Duration of disability after surgery still exists. Therefore, the objective of the present study was to compare results reached from two methods of surgery, tie-over procedure (TOP) and Karydakis procedure(KP) for the treatment of sacrococcygeal pilonidal sinus. Methods: In this study, 70 patients with a diagnosis of pilonidal sinus disease treated randomly with surgical excision and TOP or KP, in two 35 patients group, in the educational hospital by the same surgeon, between 2009 and 2010, and followed up until December 2019. Results: Achieved data after excision of sacrococcygeal pilonidal sinus indicate that primary closure of the wound by tie-over sutures have a better result than KP in order of Pain sore during the first month after surgery (P< 0.001), Duration of disability (P <0.001), wound repair time (P <0.001) and Patient satisfaction(P=0.019). Conclusion: Overall, these results show the TOP instead of KP, because higher acceptance results may be an alternative better for the treatment of chronic pilonidal sinus for the patients who have surgery scheduled for them.
Highlights
Pilonidal sinus disease usually affects young adults and is three to four times more common in men than women [1]; its incidence is reported as 26 in 100 000 people [2]
This study aimed to compare results achieved in patients with sacrococcygeal pilonidal sinus treated with surgical excision and primary surgical wound closure with either tie-over procedure (TOP) or Karydakis procedure (KP)
The present singleblind clinical trial compared the results of two techniques of TOP and the KP in the surgical management of chronic sacrococcygeal pilonidal sinus disease
Summary
Pilonidal sinus disease usually affects young adults and is three to four times more common in men than women [1]; its incidence is reported as 26 in 100 000 people [2]. Acute abscesses are incised and drained, and chronic cases are usually treated by surgical excision followed by primary closure [11]. There are various therapeutic modalities to manage these patients, there is still controversy about choosing the best surgical technique to decrease the recurrence rate, patient discomfort, and duration of disability after surgery. The present study aimed to compare the results obtained from two surgery methods including tie-over procedure (TOP) and Karydakis procedure (KP) for the treatment of sacrococcygeal pilonidal sinus. Results: According to the results, after excision of sacrococcygeal pilonidal sinus, the primary closure of the wound by tie-over sutures had better results than KP in order of pain sore during the first month after surgery (P < 0.001), duration of disability (P < 0.001), wound repair time (P < 0.001), and patient satisfaction (P = 0.019).
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