Excision versus excision and closure by transposition rhomboid flap in the treatment of chronic pilonidal sinus

ABSTRACT

This study is a r and omized clinical prospective study done on thirty-six patients with chronic pilonidal sinus who attended the outpatient clinic of surgery. Suez Canal University during the period between June 1998 and February 2000. Patients were allocated by balanced r and omization into two equal groups. Preoperatively patients characteristics were similar in the two groups. Patients of group-1 [n=18] were treated by open excision technique and their healing by second intention while patients of group-2 [n=18] were treated by excision and transposition rhomboid flap technique and their healing by first intention. Patients of the two groups were followed up for a mean period of 15.3 +/- 4.9 months [range 6-21months]. The mean operative time was shorter in the open excision group [32 +/- 6.11 minutes] compared to that in transposition rhomboid flap group [82.3 +/- 7.37 minutes]. The difference was statistically significant. Post-operative wound infection occurred in one patient [5.56%] in the transposition rhomboid flap group, it was mild and controlled by repeated dressings and broad-spectrum antibiotic. In the open excision group, it occurred in 10 patients [55.56%] with variable degree. The difference between the two groups was statistically highly significant. The mean hospital stay was 1.8 +/- 2.13 days in the open excision group while in transposition rhomboid flap group it was 3 +/- 8.89 days. The difference between the two groups was statistically significant. Healing of wound in the open excision group occurred after a mean period of 63 +/- 12.13 days while in transposition rhomboid flap group it occurred after a mean period of 11 +/- 2.16 days. The difference between the two groups was statistically highly significant. Patients returned back to work in the open excision group after a mean period of 35 +/- 5.33 days before complete healing of their wounds while in transposition rhomboid flap group it was 17 +/- 2.32 days. The difference between the two groups was statistically highly significant. No recurrence had been recorded during follow up in patients of the two groups