Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study

Haji Barati, Babak; Ghafuri, Ali
December 2010
Tehran University Medical Journal;Dec2010, Vol. 68 Issue 9, p553
Academic Journal
Background: Gross difference in return to work exists in pilonidal sinus patients operated by primary and secondary repair. This survey was to evaluate the results of surgical management of pilonidal sinus with primary or secondary closure. Methods: In a randomized clinical trial, patients with pilonidal sinus referring to the surgical clinic of Shariati Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either excision with midline closure (primary, n=40), or excision without closure (secondary, n=40). The recorded outcomes were hospital stay, healing time, time off work, postoperative pain, patient's satisfaction and the recurrence rate. Results: Majority of the patients were male (87.50%). There was no significant difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001) and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001) were shorter in primary group; but, there were no significant differences in hospital stay and number of visits. Intensity of postoperative pain in the 1st (37.75±6.5 Vs. 43.63±5.06, p=0.001), 2nd (26.75±6.66 Vs. 34.63±5.48, p=0.001), 3rd (18.25±6.05 Vs. 27.88±6.88, p=0.001), and 7th (8.45±3.85 Vs. 17.88±6.19, p=0.001) days were lower in primary closure group. There was not significant difference in complication rates in groups. Patients' satisfaction was higher in primary group (4.15±0.53 Vs. 3.6±0.5, p=0.001). Conclusion: According to this study excision and primary closure is the preferred procedure in patients with pilonidal sinus. It has the advantages of shorter time off work; earlier wound healing, lesser postoperative pain, higher patients satisfaction and comparable complication and recurrence rates with excision and open wound.


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