Introduction
Many surgeons treat pilonidal sinus (PNS) by wide excision, leaving a lay open or a primary
sutured midline wound. Others use more sophisticated techniques such as skin flap
reconstruction.
Objectives
The aim of the study was to determine the method of excising PNS minimally under local
anesthesia and study its subsequent effects on wound closure and the healing process.
Patients and methods
This prospective study was carried out on 30 consecutive patients with primary nonrecurrent
sacrococcygeal PNS. All patients were treated surgically with minimal excision and primary
closure under local anesthesia. Parameters of follow-up included wound seroma, infection, or
disruption, in addition to pain, difficulty in mobilization, time off work, and recurrence.
Results
The mean operative time was 38 min. Hospital stay ranged from 2 to 4 h. Healing time was
14–20 days. Three cases presented with wound seroma. One patient had a wound infection.
One patient had significant wound infection and wound disruption; this patient had a recurrence
after 6 months, which was treated with wide excision and rhomboid flap reconstruction.
Conclusion
Minimal excision and primary closure for uncomplicated cases of PNS under local anesthesia
is a safe and easy operative procedure with shorter operative time, short duration of hospital
stay, less postoperative time off work, low complication rates, and low chances of recurrence. |
