Abstract
Background: Different procedures are practiced nowadays for management of pilonidal sinus disease (PSD), ranging from the minimally invasive techniques to the complex flap techniques. Each procedure has its own advantages and drawbacks in terms of patient’s satisfaction, follow up and recurrence rate. Local phenol application into the sinus track was practiced with encouraging results. The limited excision and modification of the primary closed technique has shown both low wound dehiscence and recurrence rates. The objective of this study is to evaluate and compare the local application of phenol 80% in the pilonidal sinus tracks after minimal debridement with the limited excision and modified primary closure technique. Methods: 52 patients suffering from chronic pilonidal sinus disease were divided equally into 2 groups. Patients in group I were managed with local phenol application under local anesthesia. In group II, the patients were operated upon by limited excision of the skin bearing the sinus pits and the underlying granulation tissue with modified primary closure technique using the gluteus maximus fasciae to close the cavity left followed by closure of the subcutaneous tissue and skin with leaving a suction drain inside. Results: The median duration of phenol applications procedure was 20 ± 11 minutes versus 41 ± 13 minutes in the modified primary closure technique. There was a significant difference between both groups as regards the duration of pain killers’ use. By 5 weeks, signs of complete healing were shown in 22 patients (84.5%) of the phenol group, versus 25 patients (96.2%) in the surgery group with no statistic difference between both. The recurrence of PSD in the phenol group was detected in 2 cases (7.7%) while it was one case (3.8%) in the surgery group (p=0.163). Conclusion: both procedures are simple, less surgically demanding, having simple postoperative care, low complication and recurrence rates, early recovery and good patient satisfaction.
Highlights
Pilonidal sinus disease (PSD) is a common chronic inflammatory disease affecting the subcutaneous tissue of the sacrococcygeal area
The objectives of this study is to evaluate and compare the local application of phenol 80% in the pilonidal tracks after minimal debridement with the limited excision and modified primary closure technique
52 patients with chronic pilonidal sinus diseases filling the criteria of selection were enrolled in this study in October 6 university hospital
Summary
Pilonidal sinus disease (PSD) is a common chronic inflammatory disease affecting the subcutaneous tissue of the sacrococcygeal area. Different procedures are practiced nowadays for management of pilonidal sinus disease (PSD), ranging from the minimally invasive techniques to the complex flap techniques. The objective of this study is to evaluate and compare the local application of phenol 80% in the pilonidal sinus tracks after minimal debridement with the limited excision and modified primary closure technique. In group II, the patients were operated upon by limited excision of the skin bearing the sinus pits and the underlying granulation tissue with modified primary closure technique using the gluteus maximus fasciae to close the cavity left followed by closure of the subcutaneous tissue and skin with leaving a suction drain inside. Conclusion: both procedures are simple, less surgically demanding, having simple postoperative care, low complication and recurrence rates, early recovery and good patient satisfaction
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