Does technique alter quality of life after pilonidal sinus surgery?
BACKGROUND
Pilonidal sinus is a common disease in young adults that carries high postoperative morbidity and patient discomfort. Controversy still exists about the best surgical technique for the treatment of the disease in terms of recurrence rate and patient discomfort.


METHODS
From January 2000 to November 2003, 100 consecutive age- and sex-matched patients with chronic pilonidal sinus disease were randomized to receive surgical treatment in the forms of either excision and primary closure or rhomboid excision and Limberg flap. Time to return to work and to complete healing were recorded. To evaluate quality of life and patient comfort, all patients were asked to complete a questionnaire including short form 36, Visual Analogue Scale, time to sitting on toilet without pain, and time to walking without pain 3 months after surgery.


RESULTS
Each group was composed of 50 patients. Mean follow-up was 19 months. There was a significant difference between the groups in terms of length of hospital stay (P=.005), time to complete healing (P<.001), time off work (P<.001), and wound infection rate (P=.03). Statistically significant differences were noted between the groups in items of general health perception (71.1+/-11.7 vs 78.2+/-14.1; P=.008), social functioning (87.3+/-32.8 vs 110.4+/-33.8; P=.001), and pain (54.5+/-14.0 vs 67.5+/-18.4; P<.001). Times to sitting on toilet and walking without pain showed significant differences between the groups (P=.006 and P<.001, respectively). The mean postoperative Visual Analogue Scale scores were 6.5+or= 1.7 and 7.4+/- 1.4, respectively (P<.001).


CONCLUSIONS
Shorter hospital stay, earlier healing, shorter time off work, lower ratio of complications, lower pain perception, and improved general health perception are the main advantages of te Limberg flap technique in pilonidal sinus surgery. All together, these parameters add to patient comfort and satisfaction after surgical treatment.
Ertan
Tamer
T
Fifth Department of Surgery, Ankara Numune Training and Research Hospital, Yunusemre Cad. No: 45/9, 06280 Incirli, Ankara, Turkey. tertan70@hotmail.com
Koc
Mahmut
M
Gocmen
Erdal
E
Aslar
A Kessaf
AK
Keskek
Mehmet
M
Kilic
Mehmet
M
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D010864:Pilonidal Sinus / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D013524:Surgical Flaps