Comparison of primary repair with healing by secondary intention for the treatment of pilonidal sinus, at a Tertiary Care Hospital in Karachi, Pakistan.

The aim of our study is to assess the surgical outcome of healing by primary intention and compare it with primary repair for the treatment of pilonidal sinus. Study Design: Randomized controlled trial. Setting: Tertiary Care Center in Karachi Pakistan. Period: Two years from April 2015 to April 2017. Materials and Methods: 60 patients were divided into two groups by utilizing a Random Allocation Software. All the patients involved in the study signed a duly informed consent. The inclusion criteria were patients who presented to us with a pilonidal sinus and agreed to participate in the study. All the procedures were performed by the same team of surgeons. Patient follow up was bi-weekly at the outpatient. Data were collected in a predesigned proforma with various variables such as patient demographics, clinical findings, treatment option used, postoperative results, complications (if any), healing time, length of hospital stay and time for a return to function among others. The data were analyzed using IBM SPSS version 21.0. A p value of less than 0.05 was considered to be statistically significant. Results: N= 60 patients were included in the study. There were n= 51 men (85%) and n= 9 women (15%). The mean age of patients in group A was 26.45 +/- 5.81 years and the mean age of participants in group B was 27.10 +/- 5.75 years. Symptoms lasted for 6.52 +/- 2.03 days, the most common presenting complaint was pain in 51.66% of patients followed by discharge in 40% and swelling in 33.33% respectively. The mean length of stay at the hospital for both the groups was 4.40 +/- 2.11 days (4.09 +/- 1.96 days in group A and 4.85 +/- 2.33 days in group B), mean time to return to normal functioning was 17.88 +/- 8.46 days (14.50 +/- 7.30 days in group A and 23.80 +/- 6.50 days in group B). The mean healing time postoperatively for both the groups was 39.98 +/- 24.46 days (21.90 +/- 10.15 days in group A and 67.30 +/- 9.09 days in group B. Early postoperative infection was found in n=7 (11.66%) patients, wound necrosis was found in n= 2 (3.33%) patients, and recurrence of the pilonidal sinus was found in n= 3 (5%) of the patients respectively. Conclusion: According to the results of our study primary closure technique provides better outcomes in terms of early return to functioning, shorter duration of wound healing and lower rates of wound infection as compared to excision and healing by secondary intention.

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Superiority of Spacer/Mask Topical Anesthetic Compared with Conventional Spray and Gargle Method for Fibreoptic Bronchoscopy

Canadian Respiratory Journal ◽

10.1155/1996/289802 ◽

1996 ◽

Vol 3 (3) ◽

pp. 176-180

Author(s):

RC Balkissoon ◽

L Clelland ◽

L Whitehead ◽

MT Newhouse

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Fibreoptic Bronchoscopy ◽

Care Hospital ◽

Topical Anaesthetic ◽

Vocal Cords ◽

Group A ◽

Gag Reflex ◽

The Mean ◽

Group B

OBJECTIVE:To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.DESIGN:Single-blind randomized control trial.SETTING:University affiliated tertiary care hospital, ambulatory care bronchoscopy unit.SUBJECTS:Thirty consecutive consenting patients referred for fibreoptic bronchoscopy for various indications.INTERVENTION:Thirty randomized subjects received 150 mg of topical 1% aerosolized lidocaine via standard long needle nosed applicator (group A) or via a new oral/ nasal mask with spacer device (group B). Bronchoscopists, blinded as to the preprocedure topical anaesthetic method used, gave additional topical lidocaine at their discretion.MEASUREMENTS:The study nurse recorded the total dose of lidocaine (mg), timing of the procedure (s), cough frequency expressed as coughs per minute (c/min), vital signs, time for return of gag reflex and patients' subjective comments.RESULTS:Fifteen patients were randomized to each group. The lidocaine dose required for insertion through the vocal cords (mean ± SD) was 282.6±66.3 mg in group A and 203.3±70.6 mg in group B (PÃ0.005). Total lidocaine dose required for the procedure was 330.6±70.2 mg in group A and 256.6±75 mg in group B (PÃ0.01). The mean time for passage of the bronchoscope from mouth entry to through the vocal cords was 82.7±54.5 s in group A and 110.5±64.4 s in group B (P>0.1). The mean total time for the procedure was 699.7±377.5 s in group A and 697.2±409.1 s in group B (not significant). The mean cough frequency was 8.2±6.1 c/min in group A and 7.0±5.7 c/min in group B (not significant). There were no statistically significant differences in heart rate, in return of gag reflex time or in complication rate between the two groups.CONCLUSIONS:A statistically significant reduction in the dose of lidocaine is required to achieve equivalent topical anaesthetic for bronchoscopy with a new mask and spacer device compared with a more conventional method. Since no other variables related to the procedure showed a significant difference, the new method appears to be superior to the previous method.

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EFFICACY OF CIPROFLOXACIN AND CEFOTAXIME IN PATIENTS WITH CIRRHOSIS LIVER PRESENTING WITH SPONTANEOUS BACTERIAL PERITONITIS TO A TERTIARY CARE HOSPITAL

Journal of Medical Sciences ◽

10.52764/jms.21.29.2.2 ◽

2021 ◽

Vol 29 (02) ◽

Author(s):

Zahidullah Khan ◽

Ahmar Rashid ◽

Iqbal Haider ◽

Shams Suleman ◽

Aliena Badshah ◽

...

Keyword(s):

Spontaneous Bacterial Peritonitis ◽

Tertiary Care ◽

Care Hospital ◽

Bacterial Peritonitis ◽

Source Of Infection ◽

Key Words Ciprofloxacin ◽

Single Center Study ◽

Group A ◽

The Mean ◽

Group B

Spontaneous Bacterial Peritonitis (SBP), a known complication of cirrhosis Liver is an acute bacterial infection of the peritoneum. Usually no source of infection is easily identifiable. Objective: To compare the efficacy of Ciprofloxacin and Cefotaxime in Cirrhosis Liver patients with SBP. Material and Methods: This prospective, comparative, single center study was conducted in the Department of Medicine, Khyber Teaching Hospital Peshawar from 1st October 2017 to 31st December 2018. A total of 300 admitted patients having Cirrhosis Liver with SBP were included in this study. The patients were randomized into Group A and Group B. Group A was treated with Intravenous Ciprofloxacin and Group B was treated with Intravenous Cefotaxime given twice daily for a period of 5 days. Diagnostic peritoneal paracentesis was done before the start of the treatment and repeated after 5 days therapy. Patients who were either non cirrhotic or had secondary bacterial peritonitis were excluded from the study. Results: A total of 300 Cirrhosis Liver patients with SBP were studied in two equal randomized groups. Out of these 168 were male and 132 were female. The mean age of patients in study was 51.14±11.9 years. The age ranged between 15-75 years. In Group A, 82 percent responded to ciprofloxacin and in group B, 86 percent responded to cefotaxime. Conclusion: Both intravenous ciprofloxacin and cefotaxime are effective in treating spontaneous bacterial peritonitis in patients with Cirrhosis Liver. Key Words: Ciprofloxacin, Cefotaxime, Spontaneous bacterial peritonitis, Efficacy.

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EFFECT OF SINGLE-DOSE PREGABALIN ON POSTOPERATIVE PAIN IN DACRYOCYSTORHINOSTOMY SURGERY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i5.5418 ◽

2021 ◽

Vol 71 (5) ◽

pp. 1553-58

Author(s):

Sana Abbas ◽

Saquib Naeem ◽

Amjad Akram ◽

Beenish Abbas ◽

Rashid Iqbal

Keyword(s):

Tertiary Care ◽

Care Hospital ◽

Pain Scores ◽

Post Operative Pain ◽

Opioid Administration ◽

Quasi Experimental ◽

Group A ◽

The Mean ◽

Group B ◽

Study Participants

Objective: To evaluate the analgesic potential of pregabalin in ambulatory dacryocystorhinostomy surgeries under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Tertiary Care Hospital Rawalpindi, from Nov 2019 to Sep 2020. Methodology: A total of 110 patients undergoing ambulatory dacryocystorhinostomy surgery at our hospital were included in the study. Participants were divided into two groups, group A (n=55) were administered 150 mg oral pregabalin, while a placebo was given to participants of group B (n=55). Post-operative pain was assessed at recovery, four and eight hours after surgery with the help of the visual analogue scale. Results: Mean age of participants was 43.05 ± 7.5 years. Gender wise distribution showed 62 (56.4%) males and 48 (43.6%) females. At recovery, four and eight hours after surgery the mean pain scores in group A (pregabalin) vs group B (placebo) were (2.98 ± 0.8 vs 4.98 ± 0.8, p<0.001, 2.67 ± 0.6 vs 5.02 ± 0.8, p<0.001 and 1.49 ± 2.9 vs 2.95 ± 0.8, p<0.001 respectively). Opioid administration frequency in trial versus placebo group was [11 (20%) vs 32 (58.2%), p<0.001]. Conclusion: Pregabalin has analgesic potential moreover decreased postoperative consumption of opioids and associated adverse effects such as nausea and vomiting. Hence making it a suitable agent for pain relief in ambulatory surgeries.

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Comparison of two Different Surgical Modalities in the treatment of Pilonidal Sinus (Primary Closure and Open Technique)

10.53350/pjmhs2115112999 ◽

2021 ◽

Vol 15 (11) ◽

pp. 2999-3001

Author(s):

Muhammad Aamir Jamil ◽

Muhammad Imran Anwar ◽

Muhammad Waqas Saleem ◽

Sameen Tahir ◽

Haroon Javaid Majid

Keyword(s):

Pilonidal Sinus ◽

Primary Closure ◽

Pilonidal Sinus Disease ◽

Open Technique ◽

Sinus Disease ◽

Closed Technique ◽

Secondary Intention ◽

Group A ◽

The Mean ◽

Group B

Background: Pilonidal sinus is disease of young age andits prevalence is higher in men compared to women (almost twice).It is a disease that arises from hair follicles particularly present in the natal cleft. It occurs commonly in Jeep Drivers and hence gets the name from there “Jeep Drivers Disease” and also commonly occurs in Barbers. It leads to formation of abscesses and chronic wounds with discharge and pain. Disease can have huge impact on social life and quality of life. In most cases the treatment is incision and drainage. Study design: It is a case series study. Place and duration of study: Department of General Surgery at Shaikh Zayed Hospital Lahore from January 2019 to January 2021. Aim: To compare the relative effects of open and closed surgical techniques on the recurrence rate, rate of infection and time of healing for pilonidal sinus. Methodology: Patients with pilonidal sinus disease from January 2019 to January 2021 received surgical treatment either excision followed by primary closure as in closed technique (group A) or excision followed by leaving the wound open for healing by secondary intention as in open technique (group B). Surgical management is widely based upon two techniques open and closed. In open technique wound is left open and heals by secondary intention while in closed technique it is closed primarily and heals by primary intention. The better choice between these two techniques is still a topic of debate. Results: The most common age group for pilonidal sinus was between 16-25 years of age. The mean age came out to be 26.7 years. The mean healing time was 15 days in group A and 42 days in group B. The duration of hospital stay ranged between 2-8 days for group A and 5-16 days for group B. Early postoperative complications seen was infection in 1 patient (7.69%) in group A and 5 patients (35.71%) in group B and these cases were managed conservatively.1 (7.69%) case of aseptic gaping of wound after stitch removal was seen in group A and was managed with closed technique. Recurrences reported in group A was 1 case (7.69%) at 6 months and was surgically managed by open technique. There were a total of 4 (28.57%) recurrences which were left open to heal by granulation. Conclusion: It is concluded that better management option for pilonidal sinus disease is primary closure of defect. So it is suggested that management of pilonidal sinus disease should be individualized but preference must be given to closure of wound after excision. Keywords: Pilonidal sinus, Primary Closure, Open Technique.

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A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

Indian Journal of Physiology and Pharmacology ◽

10.25259/ijpp_257_2020 ◽

2021 ◽

Vol 64 ◽

pp. 298-302

Author(s):

Ritika Singla ◽

Neetu Sharma

Keyword(s):

Opportunistic Infections ◽

Tertiary Care ◽

Cd4 Count ◽

Hiv Positive ◽

Care Hospital ◽

Immunodeficiency Virus ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

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Vaginal progesterone after tocolytic therapy in threatened preterm labour

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203301 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3233

Author(s):

Aparajita Ashok Mishra ◽

Shilpa N. Chaudhari

Keyword(s):

Preterm Labour ◽

Tertiary Care ◽

Control Group ◽

Care Hospital ◽

Positive Effects ◽

Gestational Age At Delivery ◽

Group A ◽

The Mean ◽

Group B ◽

Micronized Progesterone

Background: Currently preterm labour is one of the most challenging problem faced by both obstetricians and perinatologists, this episode in the course of woman’s pregnancy takes a heavy tool for perinatal mortality which accounts for approximately 50-75%. The incidence of preterm labour is estimated to be 5-10% of all pregnancies.Methods: It was a prospective randomize control trail over a period of 3 year at department of obstetrics and gynecology, tertiary care hospital Pune, Maharashtra, India. Total 100 subjects were randomized into two groups with group one receiving vaginal micronized progesterone and group two control group receiving only tocolytics and steroids. Subsequently authors compared the safety and efficacy of vaginal micronized progesterone versus placebo as a maintenance therapy in preventing preterm labour.Results: This analysis showed that women who randomized to progesterone prophylaxis had a significantly increase in duration of pregnancy. The mean of birthweight in Group A and Group B was 2963±36 gm and 2567±49 gm and respectively which confirmed the positive effects of progesterone on increasing infants’ weights at birth.Conclusions: Authors concluded that progesterone therapy had acceptable efficacy in the prevention of preterm labor in terms of prolongation of delivery and by increasing gestational age at delivery.

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Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v10i1.38899 ◽

2018 ◽

Vol 10 (1) ◽

pp. 23-27

Author(s):

Nirupama Saha ◽

Nadiuzzaman Khan ◽

Mirza Kamrul Zahid ◽

Shah Alam Talukder ◽

ASM Meftahuzzaman

Keyword(s):

Abdominal Surgery ◽

Tertiary Care ◽

Major Abdominal Surgery ◽

P Value ◽

Care Hospital ◽

Intravenous Lidocaine ◽

Operative Outcomes ◽

Group A ◽

Randomized Control ◽

Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

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Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20194216 ◽

2019 ◽

Vol 8 (10) ◽

pp. 2197

Author(s):

Shubhatara Swamy ◽

Vijaya Rajendran ◽

Durga Prasan ◽

Pratibha Nadig

Keyword(s):

Tertiary Care ◽

Nausea And Vomiting ◽

Research Centre ◽

Care Hospital ◽

Serious Adverse Events ◽

Female Ratio ◽

First Line Therapy ◽

Significant Difference ◽

Group A ◽

Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

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Hearing results in modified radical mastoidectomy with type III tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194933 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1629

Author(s):

Yash D. Lavana ◽

Ajay J. Panchal ◽

Vaibhav B. Hapalia ◽

Manit M. Mandal ◽

Shivani D. Shah

Keyword(s):

Chronic Otitis Media ◽

Ossicular Chain ◽

Septal Cartilage ◽

Mastoid Cavity ◽

Head Group ◽

Care Hospital ◽

Modified Radical Mastoidectomy ◽

Group A ◽

The Mean ◽

Group B

Background: The objective of the study was to hear the results in patients with atticoantral-chronic otitis media who undergone canal wall down mastoidectomy with different types of tympanoplasty.Methods: 86 cases of CSOM-AA were included. Patients were divided in 3 groups according to intra-operative ossicular chain status and reconstruction. Group A were patients having intact stapes superstructure and the graft kept over the stapes head covering middle ear and mastoid cavity. Group B patients were with intact superstructure of stapes and graft kept over cartilage graft kept on mobile stapes head. Group C patients were with absent superstructure of stapes with intact, mobile footplate and graft kept over autologous or homologous cartilage kept on footplate of stapes. On 10th week and 24th week after surgery, PTA was carried out to compare pre and post-operative hearing status. The study was conducted at SMIMER Hospital, Surat (a tertiary health care hospital) fromSeptember 2016 to September 2017. Results: In 86 patients, average mean preoperative AC threshold was 48.16 (±15.15) dB, mean pre-operative BC was 8.96 (±7.85) dB and mean pre-operative air bone gap was 40.11 (±12.92) dB. The mean post-operative AC threshold was 43.17 (±13.72) dB, mean post-operative BC was 11.34 (±9.44) dB and postoperative air bone gap was 32.06 (±11.62) dB. The mean air bone gap closure was 8.76 (±11.86). This hearing gain was statistically highly significant (p<0.001). Among 86 patients, cartilage was used in total 60 patients. Mean ABG was 8.6 dB, 11.05 dB and 8.43 dB respectively for tragal, conchal and homologous septal cartilage. Conclusions: Hearing improvement can be achieved with appropriate reconstruction in CWD mastoidectomy.

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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.

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