Abstract
Pilonidal sinus (PS) is considered to be the acquired disease of especially in the sacrococcygeal region. Various primary or secondary or flap methods, accompanied by one of local curettage, phenol application, electro-cauterization and total sinus excision methods, are used for the treatment of pilonidal sinus. However, currently there is not a single widely accepted treatment method. Ninety-eight patients who had operation for PS in Atatürk University, Department of General Surgery between January 2012 and August 2014 were included in this study. The patients were categorized into two groups: first, the patients undergone total sinus excision with primary closure (Group 1), and second, patients undergone total sinus excision with modified primary closure (MPC) (Group 2). Among all 98 patients participated in this study, age, sex, type of operation, duration of operation, amount of excised skin, duration of postoperative stay at hospital and complications were evaluated. Forty-four patients (44.9%) underwent primary closure method, while 54 patients (55.1%) underwent MPC method. Mean duration of operation was 39.1 (30-60) minutes, mean diameter of excised material was 9.3 (8-11) cm(2) and mean duration of stay at hospital was 1.4 (1-3) days for the patients in the first group. Meanwhile, duration of operation was 52.2 (35-70) minutes, mean diameter of excised material was 2.6 (2-4) cm(2) and mean duration of stay at hospital was 1.6 (1-3) days for the patients in the second group. There was statistically significant difference between the two groups by means of duration of operation, dehiscence of surgical wound, recurrence and development of general complications (p<0.001, p<0.05, p<0.05 and p<0.005, respectively). According to the multivariate analysis, during surgical treatment of pilonidal sinus, primary closure method increases the rate of complication 6.65 times and MPC method increases the duration of operation 1.2 times. We hereby suggest that MPC method could be a good alternative for surgical treatment of PS, because it causes fewer complications and recurrence.
Highlights
Pilonidal sinus (PS) is considered an acquired disease, mostly seen in the sacrococcygeal region [1]
While many techniques for surgical treatment of pilonidal sinus have been defined, there is no consensus on a single treatment method and various clinical results are still being reported about these methods [2, 3]
The present pilonidal sinus tissue was totally excised from the surrounding tissues by observing its borders with strict bleeding control to leave no blood at operation field
Summary
Pilonidal sinus (PS) is considered an acquired disease, mostly seen in the sacrococcygeal region [1]. 25-50% of pilonidal disease has been reported to not involve any hair [1]. Various primary or secondary or flap methods, accompanied by one of local curettage, phenol application, electrocauterization and total sinus excision methods, are used for the treatment of pilonidal sinus [3]. The defect observed after total sinus excision could be closed by marsupialization, primary closure or flap methods. While many techniques for surgical treatment of pilonidal sinus have been defined, there is no consensus on a single treatment method and various clinical results are still being reported about these methods [2, 3]. The optimal method should have fewer complications, shorter stay at hospital, less recurrence rate, less esthetical concerns after the operation and let the patient return to social life earlier [3]
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