The treatment of non complicated sacrococcygeal pilonidal sinus by minimal excision and primary closure technique


Background: The surgical treatment of pilonidal sinus varies from wide excision and laying the wound open or excision with primary closure or excision with the use of skin graft in some special cases.Objectives: The objectives of this study is to determine the efficacy of treating non complicated pilonidal sinus disease with minimal excision and primary closure technique, complications and recurrence rate.Patients and methods: This is a prospective study conducted in shahid ahmed ismaiel hospital in rania – As sulaimania IRAQ during the period from December 2013 to January 2016 and was carried on one hundred (100) consecutive patients with non complicated non recurrent pilonidal sinus patients who were treated with minimal excision and primary closure technique. The data were analyzed focusing mainly on complications mainly infection, gapping, wound disruption, recurrence rate and patient’s compliance to antibiotics use and local wound care.The results obtained were compared with other similar studies.Result: One hundred patients with non complicated pilonidal sinus were treated with minimal excision and primary closure technique.Fifteen patients developed superficial wound infection, seventeen patients developed simple superficial wound gapping .Three patients developed deep wound infection with disruption. Four patients developed recurrence and they were treated with re-excision and skin graft placement. Minimal follow up was six months, Operations were done under general or spinal anesthesia .operative time ranged between 12 to 22 minutes (mean time 17 minutes).Conclusion: Minimal excision and primary closure technique for the treatment of pilonidal sinus disease is associated with short hospital stay, shorter off work time, less cost, low complications rate and low chance of recurrence.Key words: Pilonidal sinus, minimal excision, primary closure, recurrence rate.