title: Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. combined prospective study and randomised controlled trial.
abstract: OBJECTIVE
  To find out whether failure of primary wound healing after excision and primary suture for chronic pilonidal sinus predicts recurrence.
  
  
  METHODS
  Follow-up of one prospective study and one subsequent randomised, multicentre study.
  
  
  METHODS
  Three teaching hospitals in WesternNorway.
  
  
  METHODS
  A total of 197 consecutive patients operated on for chronic pilonidal sinus.
  
  
  METHODS
  Fifty two patients in the prospective group were given cloxacillin perioperatively. In the randomised study, 145 patients were randomised to have either a single preoperative dose of cefoxitin 2 g intravenously (n = 73) or no prophylaxis (n = 72). Patients were followed up for a median of 7 years.
  
  
  METHODS
  Recurrence of pilonidal sinus.
  
  
  RESULTS
  In the prospective group there were 10 recurrences (19%). In the randomised study 6 patients (8%) who had been given antibiotic prophylaxis had a recurrence compared with 14 patients (19%) who had not been given prophylaxis (p = 0.09). In both groups, failure of primary normal healing was significantly associated with early recurrence (p = 0.0002). Neither the use of antibiotics nor sex had any significant influence on the incidence of recurrences. Most recurrences occurred within the first year.
  
  
  CONCLUSIONS
  Wound complications significantly influenced the recurrence rate whereas antibiotics did not. Most recurrences were seen early.
authors.affiliation: Department of Surgery, Rogaland Central Hospital, Stavanger, Norway. kasoende@online.no
authors.forename: Karl
authors.initials: K
authors.lastname: Søndenaa
authors.forename: Remi
authors.initials: R
authors.lastname: Diab
authors.forename: Idunn
authors.initials: I
authors.lastname: Nesvik
authors.forename: Frank Petter
authors.initials: FP
authors.lastname: Gullaksen
authors.forename: Roy Magne
authors.initials: RM
authors.lastname: Kristiansen
authors.forename: Arve
authors.initials: A
authors.lastname: Saebø
authors.forename: Hartwig
authors.initials: H
authors.lastname: Kømer
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis; D002440:Cefoxitin / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D014945:Wound Healing
chemical_list: D002440:Cefoxitin; D003023:Cloxacillin