Does gentamycin affect long term recurrence rate in pilonidal sinus surgery?

Abstract

Background: The influence of topical intraoperative gentamycin on long term recurrence rate in primary pilonidal sinus surgery has not yet been investigated.Methods: One hundred and eight-seven patients following excision of primary pilonidal sinus disease (PSD) and primary symmetrical midline closure were analysed regarding the use (group 1) or non-use (group 2) of topical application of an intraoperative gentamycin sponge after a median follow-up of 16 years by a specific questionnaire.Results: The actuarial 15-year-recurrence rate in group 1 was 31% (34/111) compared to 26% (20/76) in group 2, which was statistically not different (p ¼ 0.99). Recurrences occurred with a median 2.7 (range 0.1-20.1) years after primary surgery, so time to recurrence did not differ between both groups (4.3 ± 0.8 years group 1 vs. 6.8 ± 1.5 years group 2; p ¼ 0.99).Conclusions: The suggested positive effects of topical gentamycin application on long term recurrence rate could not be confirmed. Astonishingly though, surgical infection does not seem to alter long term recurrence rate.

Practice Parameters for the Management of Pilonidal Disease–Do No Further Harm?

“…although the wound dehiscence rate appears to be lower when a gentamycin sponge is applied, 14,15 we agree that the 15-year recurrence rate is not affected in any way. the impact of routine short-term intravenous cephalosporin on the recurrence rate needs to be clarified, 16 as septic complications tend to elevate recurrence rate (D. Doll, unpublished data, 2013), making future recurrence of pilonidal disease more likely.…”

Sinus pilonidalis in patients of German military hospitals: a review

“…The examination of topical gentamycin application after surgery to reduce the rate of recurrence possibly affected by postoperative complications such as infections was examined in a separate interview with 111 patients after a mean 15.4 years. The recurrence rate was found to differ only insignificantly [ 23 ]. Given the volatile microbiological environment of the presacral area, the effect of topical antibiotics on the rate of infection and wound healing difficulties should be examined further.…”

The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

“…For example, in a study in which systemic antibiotherapy was applied, the use of clindamycin for 2 weeks did not show a significant difference in the recovery rate in primary closure procedures, whereas in another study, it was shown that leaving the wound open after the primary incision and using metronidazole for 14 days resulted in a moderately shorter recovery time . In another study suggesting the application of absorbable gentamycin on a surgery site, it has been shown that there is no clear improvement in recurrence rates . In addition, there are some publications defending the advantage of applying 10% metronidazole ointment in open wound treatment and that a single dose of antibiotherapy improves wound healing.…”