Sinotomy technique versus surgical excision with primary closure technique in pilonidal sinus disease

Background and Aims: Pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort for the patient. Although there are various therapeutic modalities to manage these patients, Controversy for choosing the best surgical technique in order to decrease the recurrence rate, patient discomfort, and Duration of disability after surgery still exists. Therefore, the objective of the present study was to compare results reached from two methods of surgery, tie-over procedure (TOP) and Karydakis procedure(KP) for the treatment of sacrococcygeal pilonidal sinus. Methods: In this study, 70 patients with a diagnosis of pilonidal sinus disease treated randomly with surgical excision and TOP or KP, in two 35 patients group, in the educational hospital by the same surgeon, between 2009 and 2010, and followed up until December 2019. Results: Achieved data after excision of sacrococcygeal pilonidal sinus indicate that primary closure of the wound by tie-over sutures have a better result than KP in order of Pain sore during the first month after surgery (P< 0.001), Duration of disability (P <0.001), wound repair time (P <0.001) and Patient satisfaction(P=0.019). Conclusion: Overall, these results show the TOP instead of KP, because higher acceptance results may be an alternative better for the treatment of chronic pilonidal sinus for the patients who have surgery scheduled for them.

Download Full-text

554 - Muzi's Tension Free Primary Closure Technique to Treat Pilonidal Sinus Disease: A Step-by-Step Video Demonstration

Gastroenterology ◽

10.1016/s0016-5085(18)34175-1 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-1273

Author(s):

Marco Gallinella Muzi ◽

Agnese Cianfarani ◽

Pietro Mascagni ◽

Francesco Taliente ◽

Claudia Mosconi

Keyword(s):

Pilonidal Sinus ◽

Primary Closure ◽

Pilonidal Sinus Disease ◽

Closure Technique ◽

Sinus Disease ◽

Tension Free ◽

Video Demonstration

Download Full-text

Local Phenol Application Versus Excision with Modified Primary Closure Technique in Pilonidal Sinus Disease: A Comparative Study

Advances in Surgical Sciences ◽

10.11648/j.ass.20180601.14 ◽

2018 ◽

Vol 6 (1) ◽

pp. 20

Author(s):

Adel Morad Abdallah

Keyword(s):

Comparative Study ◽

Pilonidal Sinus ◽

Primary Closure ◽

Pilonidal Sinus Disease ◽

Closure Technique ◽

Sinus Disease

Download Full-text

Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence

International Surgery ◽

10.9738/cc86.1 ◽

2012 ◽

Vol 97 (3) ◽

pp. 224-229 ◽

Cited By ~ 29

Author(s):

Akin Onder ◽

Sadullah Girgin ◽

Murat Kapan ◽

Mehmet Toker ◽

Zulfu Arikanoglu ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Pilonidal Sinus ◽

Primary Closure ◽

Disease Risk ◽

Pilonidal Sinus Disease ◽

Limberg Flap ◽

Sinus Disease ◽

Faculty Department ◽

Closure Method

Abstract The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P = 0.039). Regarding recurrence, family tendency (P = 0.011), sinus number (P = 0.005), cavity diameter (P = 0.002), and primary closure (P = 0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.

Download Full-text

PILONIDAL SINUS DISEASE: COMPARISON OF EXCISION AND PRIMARY CLOSURE VERSES EXCISION AND HEALING BY SECONDARY INTENTION

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2012.2.1.134-137 ◽

1969 ◽

Vol 2 (1) ◽

pp. 134-137

Author(s):

Mohammad Hussain ◽

Manzoor Ali ◽

S.M.Naeem ◽

Nisar Ali ◽

Muhammad Ismail

Keyword(s):

Local Excision ◽

Pilonidal Sinus ◽

Wide Local Excision ◽

Primary Closure ◽

Health Concern ◽

Pilonidal Sinus Disease ◽

Sinus Disease ◽

Secondary Intention ◽

Group A ◽

Group B

Introduction: Sacrococcygeal pilonidal disease is a serious health concern because of its associatedcomplications and recurrence. Pilonidal sinus disease is presented with symptoms ranging fromasymptomatic pits to painful draining lesions that are predominantly located in the sacrococcygeal region. Itis characterized by multiple subcutaneous sinuses, containing hairs. The exact etiology of the disease is notknown. Various treatment options are available. The choice of a particular surgical approach depends on thesurgeon's familiarity with the procedure and perceived results. The present study was aimed to compare twotreatment regimens i.e.excision and primary closure verses excision and healing by secondary intention.Patients and methods: The study was conducted in the department of surgery, Saidu Teaching HospitalSaidu Sharif Swat. Forty nine (49) human subjects with informed consent were included in the study.Patients were divided in two groups, depending on their preference and acceptance of the procedure.Patients in group A under went excision of the tract with primary closure of the defect by primary simpleclosure, Rhomboid Limberg flap or by Karydakis procedure. Patients in group B were those in whom sinustracts were excised and wound was left open for healing by secondary intention.Results: Out of the total 49 patients 3 (6.122%) were female. Mean age was 26 years (range 18-40years).Group A comprised of 24 patients in whom wide local excision was performed and wound was closedprimarily while Group B comprised of 25 patients who underwent wide local excision and wound was leftopen for healing by secondary intention. Mean hospital stay of patients in group B was significantly longerthan group A (p=0.002). The mean time for complete healing of the wound after primary closure wasmarkedly shorter.mConclusion: Primary closure of the wound after excision of the sinus tract is preferable over simple excisionand healing by secondary intention.Key words; Pilonidal sinus, primary closure, simple excision.

Download Full-text