Which technique for treatment of pilonidal sinus--open or closed?
OBJECTIVE
After excision of the pilonidal sinus, some surgeons leave the wound open, and others close the wound primarily. The aim of this study is to compare length of hospital stay, length of time to return to work, wound infection rate, and recurrence rate in chronic pilonidal sinus patients, after modification of both closed and open techniques.


METHODS
One hundred ten patients who had chronic-stage pilonidal sinus were randomly assigned to receive one of two excisional surgical procedures. One-half were treated by surgical excision and primary closure (closed technique, Group A). The other one-half were treated with Obeid's surgical excision (open technique, Group B).


RESULTS
Ninety-one (46 in Group A and 45 in Group B) of 110 patients were followed for a period four months to three years. Although patients with primary closure had significantly longer hospital stays (P < 0.05) than patients in the open group, they returned to work significantly earlier (P < 0.05). In Group A and Group B, infection rates were 3.6 percent and 1.8 percent (P > 0.01), and recurrence rates were 4.4 percent and 0 percent (P > 0.01), respectively.


CONCLUSIONS
Because both techniques have very low complication rates, treatment of chronic pilonidal sinus should be based on patient preference and characteristics, especially employment status.
Füzün
M
M
Izmir State Hospital, Turkey.
Bakir
H
H
Soylu
M
M
Tansuğ
T
T
Kaymak
E
E
Haŕmancioğlu
O
O
D000041:Absenteeism; D002908:Chronic Disease; D004322:Drainage / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D015993:Life Tables; D010864:Pilonidal Sinus / Q000601:surgery*; D012008:Recurrence; D013530:Surgical Wound Infection / Q000453:epidemiology; D016019:Survival Analysis; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing