Excision of the Gluteal Cleft Pilonidal Sinus, Its Track, and the Sudoriferous Gland Area En-bloc with Primary Repair in the Management of this Disease.

Abstract

IntroductionPilonidal disease is a common disease mostly affecting young males with a significant reduction in their working capabilities, hence, ideal and simple management of this disease is very important. Our study objective was to assess the recurrence rate of pilonidal sinus disease in patients with a complete excision of the pilonidal sinus, its track, and the sudoriferous gland area en-bloc with primary repair.MethodsThis descriptive study was conducted at Al-Noor Surgery, Chakwal, Pakistan, from February 2015 to July 2017. All patients who presented with acute and chronic pilonidal disease in the natal cleft, irrespective of age and gender, were included. We excluded from the study patients who had asymptomatic or recurrent pilonidal disease, previous pilonidal surgery, patients belonging to American Society of Anesthesiologists (ASA) Class III or above, immunodeficient patients, patients having bleeding disorders, patients on chemotherapy, and those diagnosed with comorbidities, e.g., anemia, tuberculosis, diabetes, and liver disease. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY, US).ResultsDuring the study period, a total of one 112 patients were included. The male-to-female ratio was 55:1. The most common age group was the 21-25 age group. Chronic pilonidal disease was the most common presentation. Mean operative time was 22.09±3.65 minutes. There were no complications like bleeding, hematoma, edema, infection, and wound dehiscence. There was no recurrence in the six months follow-up. Hospital stay was 3.13±0.62 hours.ConclusionSimple excision of acute and chronic pilonidal sinus, its track, and the linked sudoriferous gland area en-bloc, followed by primary repair, is an effective approach to deal with this pathology.