Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate

Gilani, Syeda Nadia Shah; Furlong, Heidi; Reichardt, K.; Nasr, Ayman; Theophilou, George; Walsh, T. N.

doi:10.1007/s11845-010-0532-0

Cited by 17 publications

(19 citation statements)

References 11 publications

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“…Partial wound dehiscence was encountered in 9.2% and 9% of patients in group PC and group LF, respectively. This compares well with the published series [17,19,23]. In addition, all of our patients experiencing complications were improved completely with antibiotics, simple drainage and daily dressing.…”

Section: Discussionsupporting

confidence: 92%

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Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease

et al. 2012

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PurposeThe aim of the present study was to evaluate the predictive value of volume of the specimen/body mass index (VS/BMI) ratio for recurrence after surgical therapy of pilonidal disease.MethodsNinety-eight patients with primary pilonidal disease were enrolled in this study. The VS/BMI ratio was calculated for each patient. This ratio was defined as the specimen index (SI). VS, BMI and SI were evaluated to determine whether there is a relationship between these parameters and recurrence of pilonidal disease. In addition, the predictive ability of SI for recurrence was analyzed by receiver operating characteristic (ROC) curve.ResultsVS and SI were found to be higher in patients with recurrence. ROC curve analysis showed that VS and SI are predictive factors for recurrence in patients treated with primary closure, nevertheless our new index had higher sensitivity and specificity than VS (sensitivity 85.7% vs 71.4% and specificity 90.7% vs 85.1%, respectively). The cut-off level for the greatest sensitivity and specificity for SI was 1.29.ConclusionRecurrence is higher in patients with high VS regardless of the operation method. SI may be a predictive value in patients treated with primary closure.

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Section: Discussionsupporting

confidence: 92%

“…The main aim of primary closure is rapid healing. But different recurrence rates (9 to 25%) have been reported after primary closure [16,17]. A meta-analysis comparing healing by primary closure and open healing after surgery for PD showed that recurrence was less likely to occur after open healing [18].…”

Section: Discussionmentioning

confidence: 99%

Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease

et al. 2012

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“…The conservative methods such as phenol injection, laser epilation, and shaving are used in the early stages of PSD with different success rates [8][9][10]. Surgical methods including primary closure, marsupialization, the Limberg flap, and cleft closure [11][12][13][14][15] have also been performed for treating PSD; however, there is no current agreement as to what the ideal treatment is. The preferred operation for PSD should be simple, cost-effective, and associated with minimal pain and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Modified Limberg transposition flap in the treatment of pilonidal sinus disease

et al. 2011

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“…[11121314] The main problems with the primary closure technique appear to be high-recurrence rate and high-infection rate. [4] On the other hand, patients generally complain about open-packing or marsupialization methods because of painful wound management and dressing changes.…”

Section: Discussionmentioning

confidence: 99%

“…[5791524] Postoperative esthetic satisfaction has been reported to be higher in patients with simplified closures, an advantage that appears to be due to the simplified technique itself, rather than due to differences in rates of wound infection or recurrence. [13] Avoiding flap reconstruction, the most involved aspect of the surgery can also reduce surgery time and complexity. [7] The cosmetic result was better in patients with simple closure and the flap construction turned out worst while neither wound infection nor recurrence had any influence on the cosmetic result.…”

Section: Discussionmentioning

confidence: 99%

Modified off-midline closure of pilonidal sinus disease

Saber

2014

North Am J Med Sci

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Background:Numerous surgical procedures have been described for pilonidal sinus disease, but treatment failure and disease recurrence are frequent. Conventional off-midline flap closures have relatively favorable surgical outcomes, but relatively unfavorable cosmetic outcomes.Aim:The author reported outcomes of a new simplified off-midline technique for closure of the defect after complete excision of the sinus tracts.Patients and Methods:Two hundred patients of both sexes were enrolled for modified D-shaped excisions were used to include all sinuses and their ramifications, with a simplified procedure to close the defect.Results:The overall wound infection rate was 12%, (12.2% for males and 11.1% for females). Wound disruption was necessitating laying the whole wound open and management as open technique. The overall wound disruption rate was 6%, (6.1% for males and 5.5% for females) and the overall recurrence rate was 7%.Conclusion:Our simplified off-midline closure without flap appeared to be comparable to conventional off-midline closure with flap, in terms of wound infection, wound dehiscence, and recurrence. Advantages of the simplified procedure include potentially reduced surgery complexity, reduced surgery time, and improved cosmetic outcome.

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Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate

Abstract: Excision and primary closure of chronic pilonidal sinus has low recurrence rate with early return to activities. Primary closure appears to be a cost-effective option for uncomplicated pilonidal sinus disease.

Cited by 17 publications

References 11 publications

Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease

Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease

Modified Limberg transposition flap in the treatment of pilonidal sinus disease

Modified off-midline closure of pilonidal sinus disease

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