Umbilical pilonidal sinus: Ambulatory surgical technique

Abstract

Hypothesis: Umbilical pilonidal sinus, although uncommon, can become complicated by inflammation, cellulitis and suppuration. Usually it tends to recur after conservative treatment. Various surgical procedures have been suggested for its treatment, but most of them were based on experience with few cases. Our aim is to describe a modified surgical technique at the day-hospital for the treatment and prevention of recurrent disease. Design: Retrospective case series. Settings: Unit of ambulatory surgery, regional day-hospital. Patients and surgical technique: Twelve consecutive cases of umbilical pilonidal sinus were treated at our hospital by subcutaneous excision of the involved tissue and the deep portion of the umbilicus. The operation was performed under general anesthesia. All the patients were discharged at 5–6 h after surgery. Results: Minor complications were encountered in two cases: seroma and hyperaemia of the skin treated conservatively at out patient clinic. No recurrent disease was found in two years of follow up. All the patients were satisfied with the cosmetic results of the procedure. This technique was cost effective since it was carried out as an ambulatory procedure. Conclusions: A simple surgical technique for the treatment of umbilical pilonidal sinus is proposed. Besides its satisfactory results in eradicating the disease it is cost effective.