Can the recurrence rate of open pilonidal sinus surgery be reduced by preventing premature epithelialization

Abstract

Background and objective: Many surgical options are known to treat chronic pilonidal sinus disease; the procedure that has the least recurrence rate is the open method. This study aimed to evaluate the effect of adding one step in management, on the recurrence rate of the same procedure. Methods: This is a prospective study, started at 1st Feb. 2018; the last data collection was at 31 Jan. 2020. Thirt-eight patients included in the study, all were suffering from chronic sacrococcygeal pilonidal sinus disease. Sinus excision and lying open the wound to heal by secondary intention is the procedure that is adopted.At time of follow up, frequent separation of wound edges and breaking of any premature bridging of skin at the excision site, were adopted, local anesthesia was needed in 7 patients. Results: The recurrence rate for lying open the wound to heal by secondary intention is significantly reduced from (8-21%) to (2.63%) by adding one step in management during the follow up period, this step involved the frequent separation of wound edges and breaking of any premature bridging of skin even if local anesthesia is needed. Conclusion: Preventing premature bridging of wound skin after surgical excision of pilonidal sinus can significantly reduce the recurrence rate of the procedure