Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. combined prospective study and randomised controlled trial.
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.
Søndenaa
Karl
K
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway. kasoende@online.no
Diab
Remi
R
Nesvik
Idunn
I
Gullaksen
Frank Petter
FP
Kristiansen
Roy Magne
RM
Saebø
Arve
A
Kømer
Hartwig
H
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
D002440:Cefoxitin; D003023:Cloxacillin