title: Long-term results of pilonidal sinus disease with modified primary closure: new technique on 450 patients.
abstract: Chronic pilonidal disease is a debilitating condition that typically affects young adults. Controversy still exists regarding the best surgical technique for the treatment of pilonidal disease in terms of minimizing disease recurrence and patient discomfort. The present study analyzes the results of excision with our modified primary closure. This retrospective study involving consecutive patients with pilonidal disease was conducted over a 6-year period. From January 2004 to January 2010, 450 consecutive patients with primary pilonidal sinus disease received this new surgical treatment. Times for complete healing and return to work, the duration of operation and of hospitalization, postoperative pain, time to first mobilization, and postoperative complications were recorded. To evaluate patient comfort, all patients were asked to complete a questionnaire including visual analog scale. The median long-term follow-up was 54 months (range, 24 to 84 months). Four hundred fifty consecutive patients (96 female, 354 male) underwent excision. The median age was 25 years (range, 17 to 43 years). The median follow-up period was 54 months (range, 24 to 84 months). Four hundred twenty completed questionnaires were returned (87% response rate). The median duration of hospital stay was eight hours (range, 7 to 10 hours) No patient reported severe postoperative pain. Primary operative success (complete wound healing without recurrence) was achieved in 98.2 per cent. Two (0.5%) patients had a recurrence. The mean time lost to work/school after modified primary closure was eight days. Excision and primary closure with this new technique is an effective treatment for chronic pilonidal disease. It is associated with low morbidity, early return to work, and excellent cosmetic result and a high degree of patient satisfaction in the long-term follow-up.
authors.affiliation: Department of Surgery, University of Rome Tor Vergata Faculty of Medicine, Rome, Italy.
authors.forename: Marco Gallinella
authors.initials: MG
authors.lastname: Muzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Maglio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Milito
authors.forename: Casimiro
authors.initials: C
authors.lastname: Nigro
authors.forename: Ilaria
authors.initials: I
authors.lastname: Ciangola
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bernagozzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Masoni
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D062707:Return to Work / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D014945:Wound Healing; D055815:Young Adult