PILONIDAL SINUS DISEASE: COMPARISON OF EXCISION AND PRIMARY CLOSURE VERSES EXCISION AND HEALING BY SECONDARY INTENTION
DOI:
https://doi.org/10.52206/jsmc.2012.2.1.134-137Abstract
Introduction: Sacrococcygeal pilonidal disease is a serious health concern because of its associated
complications and recurrence. Pilonidal sinus disease is presented with symptoms ranging from
asymptomatic pits to painful draining lesions that are predominantly located in the sacrococcygeal region. It
is characterized by multiple subcutaneous sinuses, containing hairs. The exact etiology of the disease is not
known. Various treatment options are available. The choice of a particular surgical approach depends on the
surgeon's familiarity with the procedure and perceived results. The present study was aimed to compare two
treatment regimens i.e.excision and primary closure verses excision and healing by secondary intention.
Patients and methods: The study was conducted in the department of surgery, Saidu Teaching Hospital
Saidu Sharif Swat. Forty nine (49) human subjects with informed consent were included in the study.
Patients were divided in two groups, depending on their preference and acceptance of the procedure.
Patients in group A under went excision of the tract with primary closure of the defect by primary simple
closure, Rhomboid Limberg flap or by Karydakis procedure. Patients in group B were those in whom sinus
tracts were excised and wound was left open for healing by secondary intention.
Results: Out of the total 49 patients 3 (6.122%) were female. Mean age was 26 years (range 18-40years).
Group A comprised of 24 patients in whom wide local excision was performed and wound was closed
primarily while Group B comprised of 25 patients who underwent wide local excision and wound was left
open for healing by secondary intention. Mean hospital stay of patients in group B was significantly longer
than group A (p=0.002). The mean time for complete healing of the wound after primary closure was
markedly shorter.
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Conclusion: Primary closure of the wound after excision of the sinus tract is preferable over simple excision
and healing by secondary intention.
Key words; Pilonidal sinus, primary closure, simple excision.
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