Outcome of drainage and irrigation with antiseptic in patients with pilonidal sinus undergoing excision and primary closure

Abstract EN

Background : Pilonidal sinus (PS) is a common disorder of the sacrococcygeal region.

Although an acquired basis to PS is widely accepted, a number of theories relating to pathogenesis have been proposed.

Despite controversy about the best surgical technique for the treatment of PS, no surgical procedure satisfies the principal requirements of an ideal treatment, and recent reports have advocated different surgical approaches.

Aim : The purpose of our study was to review the outcome of drainage and irrigation with antiseptic in patients with PS undergoing excision and primary closure.

Methods : The current study was performed on 20 patients with PS disease.

All patients underwent excision with primary closure associated with suction drainage of the wound and irrigation with antiseptic solution.

All consecutive eligible patients were included in this study.

However patients with acute abscesses, recurrent pilonidal sinus disease, those with more than one lateral orifice, and those with the lower central pit near the anal verge were excluded.

Results : Primary healing with no postoperative complications occurred in 17 patients (85%).

Two patients (10%) had postoperative wound infections requiring incision, drainage and lay-open for wound dressing and healing by secondary intention.

One patient (5%) developed minor wound dehiscence necessitating follow up for wound care and dressing.

Patients were followed up for 12 months and there have not been any recurrences.

Conclusions : Excision with primary suture and wound suction drainage using antiseptic-saline irrigation are valuable for primary intention healing and the avoidance of recurrences in patients with uncomplicated pilonidal sinus disease.

More advanced flap techniques and plasties may however, be allocated to patients with complicated pilonidal sinus disease if repeated recurrences and more dispersed systems of fistulas necessitate wider excisions.