PILONIDAL SINUS: COMPARATIVE STUDY - OPEN OR CLOSE PROCEDURE

Abstract

ABSTRACTBackground Pilonidal disease is a disabling nuisance in young adults, yet its management remains controversial. Ambulatory treatment with minimal morbidity and a rapid return to normal activity is desirable. Objective Many techniques have been described for the treatment of patients with pilonidal sinus. The aim of this study is to compare two methods of surgical treatment of pilonidal sinus with regard to cure and recurrence rates. Methods A case series study. All patients were treated as a day case surgery from January 1992- December 2001; divided in two groups: Group A ( excision as lay open method) includes 100 patients and group B ( excision and primary closure) includes 90 patients. Results: One hundred ninety patients, 165 males, 25 females were treated for pilonidal sinus over a period of 10 years. 100 patients were managed by excision only and 90 patients were managed by excision and primary closure. Operation for recurrent sinus was performed on 16 patients by open method. All cases treated as day case .The average time for healing following laying open was 45 days while in closed method was 14 days. 15 cases developed recurrence following surgery, 6 in group A (6%), including those already recurrent 16 patients, in whom one patient developed recurrence again and 9 in group B (10%). P<0.001. The mean follow up peroid was 1.5 year. Conclusion The open method has less recurrence rate than closed procedure but the later one has many advantages and more acceptable by the patients.