Excision with Primary Closure and Suction Drainage for Pilonidal Sinus in Adolescent Patients


ABSTRACT:BACKGROUND :Controversy persist regarding the treatment of pilonidal sinus. Sacrococcygeal pilonidal disease is a common chronic disorder of the natal cleft that is often considered a minor problem, but may cause substantial in convenience and local infection. Therefore, adequate treatment of a pilonidal sinus is important in order to improve the quality of life of affected patients.OBJECTIVE:To evaluate the technique of excision with primary suture and suction drainage (PSD) for the treatment of pilonidal sinus in adolescent patients.METHODS:Between 1996 and 2005, forty patients aged 14-19 years (are range 16.4) underwent PS excision with primary closure and suction drainage. Anesthesia was general in 18 (45%) and spinal in 22 (55%). Prophylactic cephalosporine was used is I.V antibiotic. Excision of the sinus done down to the social fascia. Closed continuous suction drain was used.RESULT:No complications due to the anesthesia were observed. Twenty five patients (62.5%) had day case surgery, while the others fifteen patients, (37.5%) were hospitalized for 2-4 days (average 2.3 days). The drain was removed on post operative day 3-6 days (average 3.2 days) primary healing with no postoperative complications occurred in 36 patients (90%). Postoperative infections requiring incision , drainage, and lay-open occurred in 3 cases (7.5%). No recurrence was found at 12-months follow-up. One recurrence (2.5%) was noted 2 years after surgery.CONCLUSION:Excision with primary closure and closed-suction drainage as an ambulatory procedure is thus a simple and effective method of treatment of uncomplicated PS in adolescents