OBLIQUE EXCISION WITH PRIMARY CLOSURE FOR THE TREATMENT OF PILONIDAL-SINUS

Although pilonidal disease of the sacrococcygeal region is common, con troversy still exists regarding its treatment. The goal of treatment s hould be to pre vent recurrence while minimizing the patient's postope rative pain and disability. During a two-year period, 32 consecutive p atients (Group A) were treated for chronic pilonidal disease by obliqu e excision and primary closure. The results were compared with 45 pati ents (Group B) who had been treated by vertical excision and primary c losure. Patients with acute pilonidal abscess or recurrent pilonidal d isease were excluded from the study. The mean follow-up was 15.9 month s for Group A and 19.6 months for Group B. The average length of hospi tal stay and time for return to daily activities were 3.18+/-1.31 vs. 5.53+/-4.11 days and 10.4+/-14.37 vs. 12.91+/-39.17 days in Groups A a nd B, respectively (p<0.001 and p<0.01). The overall recurrence rate w as 35.5% in Group B whereas there were no recurrences in Group A. On t he basis of our current experience, oblique excision with primary clos ure achieves the most promising treatment of this condition.