OBJECTIVE: To compare the efficacy of primary closure versus open method after excision of
pilonidal sinus.
DESIGN: Comparative study.
SETTING: Department of Surgery Liaquat University of Medical & Health Sciences, Jamshoro,
Sindh Pakistan, from January 2003 to December 2006 (4 years).
MATERIAL AND METHODS: Cases of chronic pilonidal sinus were included in this study
whereas acute sinuses and recurrent sinus were excluded. Patients were conveniently selected
for excision with closure and without closure (group A and group B). Both groups were followed
up for 18-months. Efficacy assessed and compared on the basis of operating time, duration
of postoperative hospital stay, time off work and recurrence rate.
RESULTS: Each group comprised of 20 patients. The mean age of all 40 patients was 27-years
(17-42 years). Males were 37 (92.5%) and females were 3 (7.5%). Respective observations for
both groups were mean operative time 91 min (85-95 min) and 69 min (60-75 min), mean postoperative
hospital stay 6 days (4-8 days) and 11 days (9-13 days), mean time of wound healing was
11 days (9-13 days) and 39 days (19-42 days), mean off work time was 21 days (10-26 days) and
42 days (22-46 days). Recurrence rate was 11.1% and 5.2% in group A and group B respectively.
CONCLUSION: Though it takes longer to excise pilonidal sinus with primary closure and it has
higher recurrence rate, it appears more beneficial due to reduced hospital stay, reduced healing
time and early return to work.
Key words: Pilonidal sinus, excision, primary closure, open method, comparative, recurrence.
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