EXCISION AND OPEN WOUND GRANULATION OF PI LONIDAL SINUSES - RECURRENCE RATE AND DURATION OF WORK INCAPACITY

Background and objective: There is controversy whether open or closed operative treatment of pilonidal sinuses is better, especially with re gard to postoperative recurrence rate and duration of work incapacity in these mostly young patients. Having performed radical excision with subsequent open wound healing, we have analysed recurrence rate, dura tion of sickness certification, amount of pain and general impairment in our group of patients. Patients and methods: All 103 patients opera ted on for pilonidal sinus between January 1992 and December 1994 (84 men, 19 women, mean age 28.1 [16-68] years) were sent a questionnaire to record any recurrence, duration of certified incapacity to work, am ount of pain and general satisfaction of the operation, using visual a nalogue scales. Complete answers were obtained from 86 patients (83.5% ). Results. The follow-up period ranged from 12 to 47 months postopera tively. The recurrence rate was 12.8%, median duration of work incapac ity was 4 weeks, longer for the employed and manual workers than for s elf-employed. Postoperative pain (scale of 0-6) averaged 3.3 and 2.3, respectively, for the in-hospital and post-hospital periods. Conclusio n: Taking into acount duration of incapacity, general patient satisfac tion and recurrence rate, the radical excision method with subsequent open wound granulation provides a reasonable alternative to closed met hods. But a definitive assessment of the advantages of the open method with respect to these criteria must await the results of prospective randomized series.