Opened versus closed procedures in management of pilonidal sinus (P.M.S.)

Abstract

Background: PNS is a common surgical disease and there are many methods of treatment such as wide excision of sinus and lay wound open to heal by granulation tissue (open), excision of a sinus with primary closure (closed), track debridement and excision or phenolization of epithelial pit and excision of PNS with primary closure using oblique incision. Methods: Setting: In Fallujah Teaching Hospital from Jan. 2017 to Dec. 2018. Design: Prospective study. These cases were chosen and divided into 2 groups: Group A: were treated by open procedure (31). Group B: were treated by closed procedure (27). The average period of follow up after completion of surgery was six months for both groups. Results: In group A symptomatic improvement occurs in 26 (83.8%) of patients and the duration of healing was about 45 days, 5 (16.2%) patients were delayed healing while recurrence were 4 (12.9%). In group B symptomatic improvement occurs in 19 (73.7%) of patients and the duration of healing was about 2 weeks. 8 (26.3%) patients were delayed healing while recurrence were 6 (22.2%). Conclusions: From this study we find that there is no ideal treatment of pilonidal sinus according to: 1. Meantime of healing. 2. Delay healing. 3. Recurrence.