title: A prospective randomised study comparing two treatment modalities for chronic pilonidal sinus with a 5-year follow-up.
abstract: BACKGROUND
  The optimal treatment of chronic pilonidal sinus is a matter of debate. Although excision and suture offers faster healing, it is associated with an increased incidence of wound infection. This study compared excision and primary closure of pilonidal sinus using incorporated gentamicin impregnated collagen with conventional laying open.
  
  
  METHODS
  Consecutive patients with pilonidal sinus were randomly assigned to one of two treatment groups: (1) open method-wound left open post-excision and (2) closed method-wound closed in two layers over gentamicin impregnated collagen. The main outcome measures were operating time, hospital stay, linear analogue pain scores (days 1, 2, 4, 7 and 14), healing rates, analgesic use and cost. Rate of recurrence at 5 years was further assessed by means of a telephone survey.
  
  
  RESULTS
  Sixty patients were recruited from June 1999 to December 2000. Operating time was significantly longer in the closed method. Pain scores were significantly lower for the closed group. A significantly higher proportion of closed wounds healed at 4 weeks. The overall cost per patient was significantly lower for the closed group. Recurrence rate was similar at 5 years.
  
  
  CONCLUSIONS
  Excision and primary closure over a gentamicin impregnated collagen is a cost-effective method of treating pilonidal sinuses, as it ensures faster healing, causes less pain and its long-term recurrence rates are similar to other techniques.
authors.affiliation: John Goligher Colorectal Unit, Leeds General Infirmary, Leeds, UK.
authors.forename: Milind M
authors.initials: MM
authors.lastname: Rao
authors.forename: Wojtek
authors.initials: W
authors.lastname: Zawislak
authors.forename: Raymond
authors.initials: R
authors.lastname: Kennedy
authors.forename: Robert
authors.initials: R
authors.lastname: Gilliland
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000818:Animals; D002417:Cattle; D002908:Chronic Disease; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010864:Pilonidal Sinus / Q000188:drug therapy / Q000601:surgery*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics