WHICH TECHNIQUE FOR TREATMENT OF PILONIDAL-SINUS - OPEN OR CLOSED

PURPOSE: After excision of the pilonidal sinus, some surgeons leave th e wound open, and others close the wound primarily. The aim of this st udy is to compare length of hospital stay, length of time to return to work, wound infection rate, and recurrence rate in chronic pilonidal sinus patients, after modification of both closed and open techniques. METHODS: One hundred ten patients who had chronic-stage pilonidal sin us were randomly assigned to receive one of two excisional surgical pr ocedures. One-half were treated by surgical excision and primary closu re (closed technique, Group A). The other one-half were treated with O beid's surgical excision (open technique, Group B). RESULTS: Ninety-on e (46 in Group A and 45 in Group B) of 110 patients were followed for a period four months to three years. Although patients with primary cl osure had significantly longer hospital stays (P < 0.05) than patients in the open group, they returned to work significantly earlier (P < 0 .05). In Group A and Group B, infection rates were 3.6 percent and 1.8 percent (P > 0.01), and recurrence rates were 4.4 percent and 0 perce nt (P > 0.01), respectively. CONCLUSION: Because both techniques have very low complication rates, treatment of chronic pilonidal sinus shou ld be based on patient preference and characteristics, especially empl oyment status.