Excision and primary closure of pilonidal sinus: excellent results

Abstract

Background: Pilonidal sinus (PNS) is an acquired condition described as a chronic sinus containing hairs and found between the buttocks. Best surgical method is still being searched for treatment of PNS in terms of minimizing disease recurrence and patient discomfort.Methods: The prospective study of 40 patient undergoing excision and primary closure of pilonidal sinus from October 2013 to July 2016 at Max Super Speciality Hospital Gurgaon.Results: Mean operative time was 30 minutes. One patient developed hematoma due to blockage of drain on post-operative day 2 which was flushed with saline and drain made patent, one patient developed seroma and one had wound infection. Rest other patients had uneventful course post operatively. No recurrence was noted over 6 month follow up.Conclusions: We advocate this method of treating PNS which is simple, less time consuming, short hospital stay, rapid healing, shorter time off work, minimal recurrence with excellent results.

Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy

“…Treatment of symptomatic pilonidal cysts typically involves surgical intervention, with complete excision of the abscess being the most effective method of minimizing the risk of reoccurrence. 16 After excision of the abscess, primary closure is the most common approach to treatment, with closure via primary intention being recommended to shorten time to healing and enabling a more rapid return to daily activities. 10 However, challenges to incision healing include lateral tension and the potential for contamination.…”

“…17 Lastly, Singh et al advocated for complete excision of the pilonidal sinus with primary closure to shortening hospital stay, and minimizing risk of reocurrence. 16 Several factors have been reported to contribute to a reduction of morbidity at the surgical site. Including closure without tension, appropriate exudate management, efficient blood circulation, and the use of closed incision negative pressure therapy (ciNPT).…”

“…Closing incisions following cyst removal is also a complex issue, with complications being primarily related to the lateral tension upon the sutures and excessive exudate. 15 , 16 The German National Guideline on the Management of Pilonidal Disease study recommended avoiding delayed closure due to associations with prolonged scarring and late return to daily activities, and suggested primary closure with the incision outside the intergluteal groove. 6 This procedure needs specific training owing to its technical difficulty.…”

“… 17 Lastly, Singh et al advocated for complete excision of the pilonidal sinus with primary closure to shortening hospital stay, and minimizing risk of reocurrence. 16 …”

Outcomes of Redivac Drain in Primary Closure of Pilonidal Sinus

“…One of the retrogrades of the primary technique of repair is the establishment of a dead wound region that can lead to the accumulation of blood and seroma. 10 Considering that primary-closure excision remains a common method for the treatment of pilonidal sinus 11 , it is necessary to determine the optimal way for this condition to minimize the risk of morbidity in the patients afflicted.…”