Risk factors for wound complication in pilonidal sinus procedures.
BACKGROUND
Pilonidal disease is a common condition among young people. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation. The aim of our study is to report our experience with Karydakis procedure and explore the risk factors associated with infection and poor healing in pilonidal operation.


METHODS
A 3-year experience of a Joint-Commission International accredited tertiary center in patients with pilonidal sinus operations is reported. We retrospectively reviewed the charts of unselected patients with pilonidal sinus who underwent excision and primary closure on elective basis in terms of wound healing, surgical site infection, and return to work. Variables predictive of surgical site infection and disruption were assessed by multiple logistic analyses.


RESULTS
From January 2004 to December 2006, 94 patients with pilonidal disease underwent excision and primary closure on elective basis. Incidence of surgical site infection was 12.8%. No recurrence was observed after median followup of 6 months, with interquartile range of 4 to 9 months. Smoking (p = 0.027) and obesity (p = 0.047) were independent risk factors for wound infections.


CONCLUSIONS
Excision and primary closure is an acceptable modality of treatment in nonobese and nonsmoker patients with pilonidal sinus disease. Infection rate in obese patients and smokers is unacceptably high, and active preoperative weight loss and smoking cessation or simple laid open procedure is recommended in these patients.
Al-Khayat
Haitham
H
Department of Surgery, Saad Specialist Hospital, Al-Khobar, Saudi Arabia. halkhayat@yahoo.com
Al-Khayat
Hisham
H
Sadeq
Adnan
A
Groof
Ala
A
Haider
Hani H
HH
Hayati
Hussein
H
Shamsah
Abdulla
A
Zarka
Zaki Anas
ZA
Al-Hajj
Hani
H
Al-Momen
Abdulhameed
A
D000293:Adolescent; D000328:Adult; D013505:Digestive System Surgical Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications; D010864:Pilonidal Sinus / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D018709:Statistics, Nonparametric; D013529:Surgical Wound Dehiscence / Q000453:epidemiology* / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome; D014945:Wound Healing