Haji Barati B, Ghafuri A,
Volume 68, Issue 9 (12-2010)
Abstract
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.
