Treatment of chronic pilonidal sinus with local anaesthesia: a randomized trial of closed compared with open technique

Abstract

Regarding morbidity neither technique has particular advantages over the other. The closed technique produced quicker wound healing and a quicker return to normal activity.

Prospective Analysis of Cosmesis, Morbidity, and Patient Satisfaction Following Limberg Flap for the Treatment of Sacrococcygeal Pilonidal Sinus

“…4,5 Therefore, some authors recommend a lateralization of the natal cleft to prevent midline recurrence. 6,7 With the Karydakis technique, recurrence rates of 4.6% to 6% have been reported, 8,9 but the procedure has a high infection rate of up to 46.4% with wound breakdown and subsequent open wound healing. 10 Lately, very encouraging results have been published for rhomboid excision of the natal cleft incorporating the pilonidal sinus tracks and coverage of the defect with a Limberg flap.…”

Simple day-case surgery for pilonidal sinus disease

“…Unfortunately this is not universally achieved and some centres continue to see the debilitating complications from this type of surgery, including unhealed midline wounds 74,75,81 -83 . There is no firm evidence that wide excision of the abscess is the only cause of unhealed midline wounds and there is little information on the frequency with which they occur, although it may be as high as 2-7 per cent 84,85 . However, as unhealed wounds mostly occur in the midline and as pilonidal disease is caused by the environment created by the natal cleft, it is likely that there will be a higher risk of this complication and recurrent disease if long midline wounds, sutured or unsutured, are created, as occurs after many wide excisional procedures.…”

Chirurgie du sinus pilonidal : quelle technique choisir ?

“…1) ; 20 essais randomisés [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] dont 11 comparants la technique ouverte à la technique fermée [6,8,9,[12][13][14][15][16]18,19,21], deux [2,3] concernant l'usage du bistouri élec-trique, quatre [7,11,17] comparant les différentes techniques de fermetures, deux essais [4,20] évaluant l'intérêt d'une antibioprophylaxie et du drainage postopératoire, enfin un essai [5] comparant la marsupialisation et l'excision simple. Toutes les études concernent la cure chirurgicale d'une maladie pilonidale chronique.…”

“…Trois essais randomisés [9,19,21] montraient une morbidité plus importante dans le bras technique fermée. Deux essais [12,18] n'ont pas montré de différence significative en termes de morbidité.…”