Comparison of three methods in surgical treatment of pilonidal disease.
BACKGROUND
The present study was designed to compare three methods that are still used for the surgical treatment of pilonidal disease: marsupialization, primary midline closure and skin flaps.


METHODS
One hundred and one out of a total of 203 pilonidal disease patients underwent excision and marsupialization, while 82 patients had excision and primary closure and the remaining 20 were treated with excision and skin flaps. The minimum and maximum follow-up periods for the aforementioned surgical methods were 4 and 5 years, respectively. All patients were reviewed for in-hospital stay, return to work, wound infection and recurrence rates. Student's t-test and Fisher's exact test were used for statistical analysis.


RESULTS
Average hospital stays for marsupialization, primary closure and skin flaps were 2.84 +/- 0.13, 2.62 +/- 0.12 and 5.95 +/- 0.52 days, respectively. Hospital stay for the skin flaps method was longer than that for the other two methods. The average time to return to work after marsupialization was 5.42 +/- 0.08 weeks; but the time needed to return to work after undergoing the primary closure or the skin flaps methods was much shorter: 2.15 +/- 0.05 and 2.90 +/- 0.20 weeks, respectively (P < 0.001). There was no difference in wound infection rate (P = 1.000) or recurrence rates.


CONCLUSIONS
The fact that there were no differences in terms of wound infection or recurrence rates between the three groups, and the relatively shorter period for returning to work, emphasize the usefulness of the excision and repair techniques in the surgical treatment of pilonidal disease.
Aydede
H
H
Second Department of Surgery, Izmir Atatürk State Hospital, Turkey. yoleri@superonline.com
Erhan
Y
Y
Sakarya
A
A
Kumkumoglu
Y
Y
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000534:rehabilitation / Q000601:surgery*; D011446:Prospective Studies; D055502:Secondary Prevention; D013514:Surgical Procedures, Operative / Q000379:methods; D013530:Surgical Wound Infection / Q000517:prevention & control; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing