Comparison of Primary Midline Closure and Open Surgery for Sacrococcygeal Pilonidal Sinus: A Retrospective Study

Abstract

Background: Sacrococcygeal Pilonidal sinus (SPNS) isa common problem has a variable presentation and many surgical techniques for treatment. Still, there is controversy about the best method of surgery, because of notable rates of recurrence. Objective: The aim is to clarify the better, cost-effective and less painful method for treating patients having SPNS. Methods: This is a retrospective study of 119 patients with SPNS, treated by two different surgical methods: group A (69 patients) treated with open surgery and group B (50 patients) treated by primary midline closure. The patients followed for 2 years. Comparison between the two groups was done, for post-operative complications and recurrence. The data were analyzed using of Statistical Package for Social Science (SPSS) version 21. Chi square used to determine association between variables. P value < 0.05 is regarded statistically significant. Results: From 119 patients: Group A (69 cases) underwent open surgery and group B (50 cases) had primary closure. Postoperative infection was (5.9%), bleeding (2.5%), scar fissuring (5.9%) and chronic pain (3.4%). Recurrence found in 6 patients (5%); 2(2.9%) in Group A and 4(8%) in Group B.Conclusions: The open method needs multiple dressings which are coasty and painful, longer healing time and may be complicated by scar fissuring, but of lower recurrent and infection. The closed method is preferablefor patient's comfort, and it is costeffectiveness.

Surgeons’ Experience and Practices in Managing the Pilonidal Sinus in the Kurdistan Region of Iraq

“…The second most common procedure is excision and primary closure, as they believe that it has a faster recovery and less hospital stay, although there is a higher recurrence rate [ 15 ]. A study by Shakor et al in Suleymani-Iraq concluded that the primary closure method is more comfortable for patients than the open method and is more cost-effective [ 20 ].…”

“…Reasons for performing specific procedures more frequently than other procedures are that the majority agreed on specific procedures such as excision and open method because it has a lower recurrence rate (n = 45, 43.3%), safer (n = 48, 46.2%), shorter operation time (n = 40, 38.5%), and shorter hospital stay (n = 34, 32.7%). A study by Shakor et al showed that the treatment of pilonidal sinus disease by excision and the open method has a lower infection and recurrence rate than the closed method, but it is costly and more painful [ 20 ].…”

Comparative Study between Excision of Pilonidal Sinus Via Lay Open Technique Versus Closed Technique and between Karydakis Technique Versus Limberg Technique: Meta Analysis

“…4-Regarding rate of Complications, 9 studies [4][5][6][7][8][9][10][11][12] included comparing Complications in Lay open group versus Primary closure group. A total of 147 cases showed complications in form of infection, wound dehiscence, bleeding, scar fissure and chronic pain, with total complication rate of 19.7%, 55 cases from lay open group (16.4179%) and 92 cases from primary closure group (22.549%) with insignificant differences between the two groups regarding rate of complications.…”