comparative study of excision with laying open and modified bascom's technique in sacro-coccygeal pilonidal sinus

ABSTRACT

The study aimed to compare the results of excision and laying open to achieve primary healing method to those of lateral approach [modified Bascom's procedure] in the treatment of sacro-coccygeal pilonidal sinus in regard to the hospital stay, time required for complete healing, time required to return to daily job or activity, early complications [bleeding, infection, wound hematoma or seroma] and late complications [scar and recurrence]. Methods: Eighty patients underwent elective surgery for there pilonidal sinus, 62 males, 18 females at Al-Karama Teaching Hospital [Baghdad, Iraq], between June 2009 and June 2014. Two surgical procedures were carried out, excision and laying open [40 patients, group A] and modified Bascom's procedure [lateral approach] [40 patients, group B]. Five patients omitted from further follow up, two cases related to excision and packing and three of modified Bascom's procedure. Results: It has been found that the third decade of life is the most frequent age group at which patients presenting. It has been concluded that there was no significant difference in the occurrence of the early complications [bleeding, infection, seroma/hematoma], 25% for group A and 37.5% group B, and recurrence rate 10.5% for group A and 16.2% for group B, but patients in group B provided a significantly quicker healing time [mean 49 days for group A and 28 days for group B]. Shorter time-work [mean 47.8 days for group A and 28 days for group B] with better patient convenience [more pain free period], needs only simple oral analgesia, no patient needed hospital admission for pain control, no dressing required and less risk of wound breakdown. Conclusions: The study showed that modified Bascom's procedure for pilonidal sinus is an attractive, safe, easily performed operation with minimal morbidity and feasible as day-care surgery