Abstract
There is controversy whether open or closed operative treatment of pilonidal sinuses is better, especially with regard to postoperative recurrence rate and duration of work incapacity in these mostly young patients. Having performed radical excision with subsequent open wound healing, we have analysed recurrence rate, duration of sickness certification, amount of pain and general impairment in our group of patients. All 103 patients operated on for pilonidal sinus between January 1992 and December 1994 (84 men, 19 women, mean age 28.1 [16-68] years) were sent a questionnaire to record any recurrence, duration of certified incapacity to work, amount of pain and general satisfaction of the operation, using visual analogue scales. Complete answers were obtained from 86 patients (83.5%). The follow-up period ranged from 12 to 47 months postoperatively. The recurrence rate was 12.8%, median duration of work incapacity was 4 weeks, longer for the employed and manual workers than for self-employed. Postoperative pain (scale of 0-6) averaged 3.3 and 2.3, respectively, for the in-hospital and post-hospital periods. Taking into account duration of incapacity, general patient satisfaction and recurrence rate, the radical excision method with subsequent open wound granulation provides a reasonable alternative to closed methods. But a definitive assessment of the advantages of the open method with respect to these criteria must await the results of prospective randomized series.
Published Version
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