simple method for treatment of pilonidal sinus

ABSTRACT

The multiplicity of treatment options available for pilonidal disease reflects the general controversy concerning its management. Sometimes there is no need for the more complex and time consuming procedures namely local flaps. In this study a simple technique consists of excision of the sinus[es] with primary closure after insertion of suction drain for irrigation with antiseptic solution was carried out. A total of 39 patients, 32 [82%] were males and 7 [18%] were females aged between 18-39 years; median 28.5 years with chronic pilonidal sinus[es] were included in the study. After methylene blue staining of the quiescent pilonidal sinus[es], an elliptical incision followed by excision of the sinus was carried out. After haemostasis by diathermy knife a suction drain 12 FG was brought out from the right and left side of the upper end of the wound. The wound is then closed in one or two layers. All patients had been discharged on the day of surgery or maximally the next day. Irrigation of the wound with 4-5ml of betadin solution followed by 4-5m1 of normal saline at 2nd, 4th and 6th day postoperatively at out patient clinic was done. Both limbs of suction drain were shortened 2-3cm at day 7 and removed with stitches at 10th day. Postoperatively, one patient had erythema which improved after change of the antibiotic and there were no deep wound sepsis, haematoma, seroma or necrosis of the wound edges. All wounds healed by primary intension and there was no recurrence during the follow up period [6-24 months]. This, simple procedure of pilonidal sinus excision, primary closure and application of suction-irrigation drain leads to satisfactory outcome with low morbidity rate