Treatment of pilonidal sinus disease using fibrin glue as a sealant.
BACKGROUND
Complete excision is the preferred treatment for pilonidal sinus disease. We describe a new technique of excision and tension-free primary closure of pilonidal sinus disease, combined with application of fibrin glue in order to obliterate the dead space and to promote wound healing.


METHODS
A curved incision of the carried out, 2-3 cm lateral to the opening of the sinus, done under general or spinal anesthesia, and a thick flap was created by undercutting the medial edge and advancing it across the midline. The sinus was completely excised with all of its extensions. The flap was then sutured back to its original place by several interrupted monofilament mattress sutures. Then, 2-4 ml of fibrin glue was injected through the original pilonidal sinus opening to the sinus bed in order to obliterate the dead space.


RESULTS
Thirty patients with pilonidal sinus disease were treated by this technique. In four patients, there was a temporary purulent discharge through the opening of the sinus, and there were no other complications. The mean period for returning to daily activities and to work for patients was 11 days (SD=6 days). No infection or recurrent disease was noticed during the follow-up period (23+/-3 months).


CONCLUSIONS
Complete excision with tension free closure with fibrin glue application may be a useful technique for the treatment of pilonidal sinus disease.
Department of Surgery A, Tel-Aviv Medical Center Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel-Aviv 64239, Israel. rongree@mailcity.com
R
R
Greenberg
H
H
Kashtan
Y
Y
Skornik
N
N
Werbin
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000188:drug therapy* / Q000601:surgery*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000008:administration & dosage*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives