Does pilonidal abscess heal quicker with off-midline incision and drainage?

Abstract

Pilonidal abscess should be drained away from the midline.

Converting Emergency Pilonidal Abscess Into an Elective Procedure

“…This finding is consistent with previous studies. 17,19 Webb and Wysocki 17 found that metronidazole was omitted in most antibiotic regimens used in the management of acute pilonidal disease in their institute, similar to our findings.…”

“…17 Patients with larger abscesses are probably more likely to require repeated aspiration. However, the definition of large abscess in this study (15-40 mL) is arbitrary, and the follow-up should be tailored to each patient based on clinical assessment.…”

Modified Limberg transposition flap in the treatment of pilonidal sinus disease

“…The conservative methods such as phenol injection, laser epilation, and shaving are used in the early stages of PSD with different success rates [8][9][10]. Surgical methods including primary closure, marsupialization, the Limberg flap, and cleft closure [11][12][13][14][15] have also been performed for treating PSD; however, there is no current agreement as to what the ideal treatment is. The preferred operation for PSD should be simple, cost-effective, and associated with minimal pain and postoperative complications.…”

Microbiology of the infected recurrent sacrococcygeal pilonidal sinus

“…Nevertheless, a relationship between wound infection and recurrence rate has been demonstrated . Bacteria that infect PS are reportedly sensitive to metronidazole because of the predominance of anaerobic bacteria . In a study with 50 patients who underwent excision of a PS and midline closure, Chaudhuri et al compared single‐dose antibiotic treatment with solely metronidazole with cefuroxime plus metronidazole followed by amoxicillin/clavulanic acid for 5 days and found the latter treatment to be superior .…”