Sacrococcygeal pilonidal sinus: modified sinotomy versus lay-open, limited excision, and primary closure | ||||
| The Egyptian Journal of Surgery | ||||
| Article 3, Volume 36, Issue 1, January 2017 PDF (2.33 MB) | ||||
| DOI: 10.4103/1110-1121.199901 | ||||
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| Authors | ||||
| Ahmed A. Darwish; Moheb S. Eskandaros; Ashraf Hegab | ||||
| Abstract | ||||
| Context Pilonidal sinus PNS is a common condition. Although many methods for treatment are available, there is no consensus on the optimal treatment. Aim The aim of this study was to compare the results of a modified sinotomy method with those of lay-open, limited excision, and primary closure with and without a drain in the management of a PNS. Settings and design This is a prospective randomized comparative study. Patients and material Fifty-eight patients undergoing surgery for primary PNS were enrolled. The patients were randomized into three groups: group A (17 patients) underwent modified sinotomy; group B (22 patients) underwent lay-open, limited excision, and primary closure with a drain; and group C (19 patients) underwent the same procedure as group B but without a drain. Each patient was followed up for 24 months. Statistical analysis Continuous variables were expressed as mean±SD. Categorical variables were expressed as frequencies and percentage. Results Significantly short operative time was recorded in the modified sinotomy group. Postoperative wound complications occurred in 5.9% of patients in group A, in 31.8% of patients in B, and in 21.1% of patients in group C. Significantly short time was recorded between the completion of the procedure and the patient being able to walk, sit, and sit on a toilet comfortably, as well as be able to return to work, in group A; however, the healing duration was significantly longer. Visual analogue scale score showed significantly less pain in group A. Complete wound healing occurred in all patients in groups B and C, but one patient in group A developed failure of healing. Recurrence rate was a slightly higher in group B but with no statistical significance. Conclusion The modified sinotomy technique for treatment of PNS is superior to excision with primary closure either with or without a drain with respect to operative time, hospital stay, comfort in walking, sitting, and sitting on the toilet, return to work, and visual analogue scale scores for pain, although the healing time is longer. | ||||
| Keywords | ||||
| lay-open; Pilonidal Sinus; primary closure; Sacrococcygeal; sinotomy | ||||
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