title: Effectiveness of a drain in surgical treatment of sacrococcygeal pilonidal disease. Results of a randomized and controlled clinical trial on 803 consecutive patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the influence of cavity drainage in the surgical treatment of sacrococcygeal pilonidal sinuses.
  
  
  METHODS
  The study was prospectively carried out in 803 patients randomized into two groups of respectively 401 and 402 patients. In the first group, primary excision and closure were associated with drainage of the wound; in the second group, the wound was not drained. We have analyzed time off work, time to walk without pain, time to sitting on the toilet without pain, recurrences, and wound infections. We have also evaluated the satisfaction rate and esthetic results.
  
  
  RESULTS
  On comparing time off work, time to walk without pain, and time to sitting on toilet without pain postoperatively, there were no significant differences between the two groups. A significant difference between the two groups with regard to wound infection rates (p = 0.5) and recurrence rates (p = 0.6) was not observed. In order to prevent prolonged inpatient stay and social intolerance, this study suggests that the post-operative period is tolerated by a few when a drain was used. The visual analog scale (VAS) in the drained group was 3.2 ± 0.9, and VAS in the non-drained group was 3.5 ± 0.9 with a significant statistical difference (p = 0.0001). As regards the cosmetic appearance of the scar after surgery, we achieved a high satisfaction rate among patients in either group with 82.9% good cosmetic results.
  
  
  CONCLUSIONS
  The use of a drain, in our experience, appears to be useless in achieving a quick healing of the sacral wound; in addition, it has a low satisfaction rate.
authors.affiliation: Department of Surgery, Orthopedy, Traumatology and Emergency, University of Naples "Federico II", Naples, Italy. milone.marco@alice.it
authors.forename: Marco
authors.initials: M
authors.lastname: Milone
authors.forename: Milone
authors.initials: M
authors.lastname: Marco
authors.forename: Mario
authors.initials: M
authors.lastname: Musella
authors.forename: Musella
authors.initials: M
authors.lastname: Mario
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salvatore
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giuseppe
authors.forename: Maddalena
authors.initials: M
authors.lastname: Leongito
authors.forename: Leongito
authors.initials: L
authors.lastname: Maddalena
authors.forename: Francesco
authors.initials: F
authors.lastname: Milone
authors.forename: Milone
authors.initials: M
authors.lastname: Francesco
mesh_terms: D000328:Adult; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D010864:Pilonidal Sinus / Q000601:surgery*; D012008:Recurrence; D012445:Sacrococcygeal Region / Q000473:pathology / Q000601:surgery; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome; D014946:Wound Infection / Q000209:etiology