Chronic pilonidal disease: A randomized trial with a complete 3-year follow-up

Abstract

Three treatments for chronic pilonidal disease were compared in a randomized trial. Healing without formation of new sinuses occurred equally frequent after excision (E), excision with suture (E + S) and excision with suture under cover with clindamycin (E + S + C). The times of healing were significantly shorter after E + S (median 14 days, n = 29) than after E (64 days, n = 29) and tended to be even shorter after E + S + C (11 days, n = 30). Recurrence rates within 3 years amounted to 13 per cent after E, 25 per cent after E + S and 19 per cent after E + S + C, but the total time of healing after initial surgery as well as excision of recurrences was significantly shorter after E + S than after E and tended to be even shorter after E + S + C.

Elliptical Excision with Midline Primary Closure Versus Rhomboid Excision with Limberg Flap Reconstruction in Sacrococcygeal Pilonidal Disease: A Prospective, Randomized Study

“…Outcome of our study in terms of recurrence of the sinus is the same as reported by other studies, namely, three recurrences for the primary closure group against zero recurrence of the Limberg flap group. Fist, a drawback of follow-up of less than 3 years for documenting the recurrence mars the such data of many of the studies since most of the recurrences present within 3 years of the primary procedure [9,10]. Second, most of the published studies have failed to define recurrence and the second occurrence of the disease.…”

Prospective randomized study of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention

“…The advantage of this method is that all the inflamed tissue is removed and chance of recurrence is minimum. 20 Healing time was defined as complete re-epithelization of the wound.…”

“…20 Despite this there is a role for wide excision in those with extensive chronic disease and following failed primary closure surgical technique. A modification of the standard excision is 'marsupialization'.…”

Our experience of simple technique for successful primary closure after excision of pilonidal sinus disease

“…In all patients, primary healing was achieved, a result that is similar to our own experience. Kronborg and colleagues 12 reported the results of a randomized trial of treatment by 1 of 3 methods: excision, excision with suture and excision with suture and antibiotic coverage with clindamycin. Recurrences rates were 13%, 25% and 19%, respectively.…”