title: Sinus excision and primary closure versus laying open in pilonidal disease: a prospective randomized trial.
abstract: BACKGROUND
  Surgical excision is the standard treatment for chronic pilonidal disease, but all excisional techniques are associated with tissue loss, risk of wound break down, and chronic healing problems.
  
  
  OBJECTIVE
  The aim of the study was to compare sinus excision and primary closure vs a laying open technique in a prospective randomized trial.
  
  
  METHODS
  Eighty patients were randomly assigned to sinus excision and primary closure (n = 39) or laying open (n = 41). Follow-up was performed 1, 3, and 12 months after surgery.
  
  
  METHODS
  The main outcome measure was the healing rate after 1 year.
  
  
  RESULTS
  The healing rate was significantly higher after excision and closure than after laying open at 1 month (20 of 39 vs 8 of 41; P = .005) and 3 months (36 of 38 vs 28 of 39; P = .013) after surgery. At follow-up 12 months after surgery no difference was seen in healing rate between the treatment arms (33 of 37 vs 37 of 38; P = .198).
  
  
  CONCLUSIONS
  This prospective randomized trial shows that sinus excision and primary closure results in faster healing than laying open does, but there is no difference in healing rate after 1 year. The laying open procedure is minimally invasive with small risks for the patient, and it might therefore be considered more frequently as the first choice of treatment (www.clinicaltrials.gov. Unique identifier: NCT00997048).
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Lorant
authors.forename: Ingar
authors.initials: I
authors.lastname: Ribbe
authors.forename: Haile
authors.initials: H
authors.lastname: Mahteme
authors.forename: Ulla-Maria
authors.initials: UM
authors.lastname: Gustafsson
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Graf
mesh_terms: D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010864:Pilonidal Sinus / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult