DAY CASE SURGERY FOR SACROCOCCYGEAL PILONIDAL SINUS USING EXCISION AND PRIMARY MIDLINE CLOSURE

Abstract

Sacrococcygeal pilonidal sinus (PNS) is a common disease. There are different lines oftreatment but the best surgical technique is still controversial. The aim of this study is to showthe effectiveness of treatment of sacrococcygeal PNS with excision and primary midline closureas day case surgery. This is the first study on sacrococcygeal PNS to be done in Sulaymaniagovernorate, Iraq.A prospective study was done over a period of 3 years, between 1st Jan 2003 and 31st Dec2005 in a private general surgical office, in Sulaymania city, Iraq, where 78 cases of chronicsymptomatic, uncomplicated, nonrecurrent sacrococcygeal PNS were seen. From these 78patients 6 patients refused operation and they were excluded from the study. Data collectedfrom the remaining 72 patients were age, gender, presenting complaint and its duration,operative findings, duration of the operation, time of wound healing, any hospitalization ifrequired, time to return to work, postoperative complications, postoperative pain, woundhematoma, wound infection, wound disruption, recurrence of the sinus, cost of the operation,patient satisfaction about the treatment and follow up compliance of the patients. They weretreated with excision and primary midline closure technique. From the total no of 72 patients, 7patients were unable to complete the follow up period and they were excluded from the study,and we continued the study of the outcome data of the remaining 65 patients.Of those 65 patients treated excision and primary midline closure, 1 patient (1.53%) developedwound disruption, 4 patients (6.14%) developed surgical site infection (SSI) and only 3 patients(4.61%) had reccurence of the sinus.It is concluded that excision and primary midline closure technique is simple, convenient,economic and successful treatment as day case surgery for chronic, sympotomatic,uncomplicated and non recurrent sacrococcygeal PNS.K