Surgical Treatment of Pilonidal Disease: Comparison of Three Different Methods in Fifty-Nine Cases

Abstract

The surgical treatment of pilonidal disease at the Robert Packer Hospital from 1983 to 1989 was reviewed. During that period, 59 patients were operated on for definitive treatment of the disease. The different methods of treatment, namely excision and packing (28 cases), marsupialization (11 cases), and excision and primary closure (20 cases) were compared in terms of age and sex distribution, length of hospital stay, number of post-operative visits, time required for complete healing, complications, and recurrence rate. The operations were performed by surgical residents under the supervision of board-certified surgeons. The average time for complete healing was 21 weeks, 8 weeks, and 3 weeks, respectively, for the different methods. Recurrence rates were essentially nil for all methods. It was concluded that excision and primary closure is the superior method in the treatment of pilonidal disease. The relevant literature was reviewed and the surgical technique discussed.

Surgical Treatment of the Pilonidal Disease: Primary Closure or Flap Reconstruction After Excision

“…28 However, a high complication rate has been reported because of tissue tension, 1 although some surgeons have reported good results after primary closure. 29,30 Flap techniques have been associated with lower infection and recurrence rates, shorter hospital stay, and better aesthetic results. With this technique, the internal cleft can be flattened, and tissue can be approximated without tension.…”

Versatality of Limberg Flap

“…(2)(3) Flap techniques have been associated with lower infection and recurrence rates, shorter hospital stay, and better aesthetic results. With this technique, the internal cleft can be flattened, and tissue can be approximated without tension.…”

Limberg Flap Reconstruction for Pilonidal Sinus

“…[13] However, a high complication rate has been reported because of tissue tension,although some surgeons have reported good results after primary closure. [14][15] Flap techniques have been associated with lower infection and recurrence rates, shorter hospital stay, and better aesthetic results. With this technique, the internal cleft can be flattened, and tissue can be approximated without tension.…”