title: Modified Primary Closure Method for the Treatment of Pilonidal Sinus.
abstract: OBJECTIVE
  Pilonidal sinus (PS) is considered to be the acquired disease of especially in the sacrococcygeal region. Various primary or secondary or flap methods, accompanied by one of local curettage, phenol application, electro-cauterization and total sinus excision methods, are used for the treatment of pilonidal sinus. However, currently there is not a single widely accepted treatment method.
  
  
  METHODS
  Ninety-eight patients who had operation for PS in Atatürk University, Department of General Surgery between January 2012 and August 2014 were included in this study. The patients were categorized into two groups: first, the patients undergone total sinus excision with primary closure (Group 1), and second, patients undergone total sinus excision with modified primary closure (MPC) (Group 2). Among all 98 patients participated in this study, age, sex, type of operation, duration of operation, amount of excised skin, duration of postoperative stay at hospital and complications were evaluated.
  
  
  RESULTS
  Forty-four patients (44.9%) underwent primary closure method, while 54 patients (55.1%) underwent MPC method. Mean duration of operation was 39.1 (30-60) minutes, mean diameter of excised material was 9.3 (8-11) cm(2) and mean duration of stay at hospital was 1.4 (1-3) days for the patients in the first group. Meanwhile, duration of operation was 52.2 (35-70) minutes, mean diameter of excised material was 2.6 (2-4) cm(2) and mean duration of stay at hospital was 1.6 (1-3) days for the patients in the second group. There was statistically significant difference between the two groups by means of duration of operation, dehiscence of surgical wound, recurrence and development of general complications (p<0.001, p<0.05, p<0.05 and p<0.005, respectively). According to the multivariate analysis, during surgical treatment of pilonidal sinus, primary closure method increases the rate of complication 6.65 times and MPC method increases the duration of operation 1.2 times.
  
  
  CONCLUSIONS
  We hereby suggest that MPC method could be a good alternative for surgical treatment of PS, because it causes fewer complications and recurrence.
authors.affiliation: Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Sukru
authors.initials: S
authors.lastname: Arslan
authors.affiliation: Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Karadeniz
authors.affiliation: Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Ozturk
authors.affiliation: Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Aydinli
authors.affiliation: Medical Student, Atatük University School of Medicine, Erzurum, Turkey.
authors.forename: Muhammed Cagri
authors.initials: MC
authors.lastname: Bayraktutan
authors.affiliation: Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Sabri Selcuk
authors.initials: SS
authors.lastname: Atamanalp
keywords: Pilonidal sinus; complication; modified primary closure