Pilonidal sinus: comparative study - open or close procedure

Pilonidal disease is a disabling nuisance in young adults, yet its management remains controversial. Ambulatory treatment with minimal morbidity and a rapid return to normal activity is desirable. Many techniques have been described for the treatment of patients with pilonidal sinus. The aim of this study is to compare two methods of surgical treatment of pilonidal sinus with regard to cure and recurrence rates. A case series study. All patients were treated as a day case surgery from January 1992 -December 2001; divided in two groups: Group A [excision as lay open method] includes 100 patients and group B [excision and primary closure] includes 90 patients. One hundred ninety patients, 165 males, 25 females were treated for pilonidal sinus over a period of 10 years. 100 patients were managed by excision only and 90 patients were managed by excision and primary closure. Operation for recurrent sinus was performed on 16 patients by open method. All cases treated as day case. The average time for healing following laying open was 45 days while in closed method was 14 days. 15 cases developed recurrence following surgery, 6 in group A [6%], including those already recurrent 16 patients, in whom one patient developed recurrence again and 9 in group B [10%]. P<0.001. The mean follow up period was 1.5 year. The open method has less recurrence rate than closed procedure but the later one has many advantages and more acceptable by the patients

value of palpation of patent processus vaginalis in diagnosis of pediatric indirect Inguninal Hernia

This study was undertaken to assess the importance of palpation of indirect inguinal hernia sac [patent processus vaginalis] in establishing the clinical diagnosis in infants and children. A total of 459 patients [414 males and 45 females] with indirect hernias operated on were included in this study over a period of 15 years. History taken from the mother and palpation findings of hernia sac were assessed in comparison to operative findings. In most patients the clinical diagnosis was the same as operative diagnosis, so the palpation test is very accurate method and is sufficient indication for exploration. Palpation of indirect inguinal hernia sac [patent processus vaginalis] is very useful, simple, non invasive method of preoperative evaluation of the indirect inguinal hernias, reliable in minimizing unnecessary exploration and correlate well with the operative findings even if no bulge is detected in the inguinal region