title: Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable.
abstract: A chronically infected sacral wound requiring repeated shaving, cleansing and dressing after treatment of pilonidal sinus disrupts both work and social activity.
  
  
  OBJECTIVE
  To compare delay in pilonidal sinus wound healing after laying open with that after primary closure.
  
  
  METHODS
  Healing time and recurrence were recorded in a consecutive series of 102 patients in one hospital undergoing either asymmetric primary closure (Karydakis procedure) by a single surgeon or laying open by other surgeons.
  
  
  RESULTS
  The interval from operation to cessation of wound dressing was significantly shorter (log rank test, P < 0.0003) after primary closure (median 3 weeks, iqr 3-6) compared with laying open (median 6 weeks, iqr 4-8). No primary closure (0%) and 10 laid open (19%) wounds remained unhealed at 10 weeks from operation (2 × 2 contingency table, P = 0.003). No significant difference was demonstrated (Mann-Whitney U-test) between healing time in elective (median 3 weeks, iqr 3-6) compared with emergency (median 3 weeks, iqr 3-3) admissions treated by primary closure.
  
  
  CONCLUSIONS
  Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable.
authors.affiliation: Department of Gastrointestinal Surgery, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK.
authors.lastname: Patel
authors.lastname: Lee
authors.lastname: Bloom
authors.lastname: Allen-Mersh