Pilonidal Sinus: Excision with Primary Midline Closure versus Open Method

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.