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Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus
V Viciano1, J E Castera, J Medrano
1Department of Surgery, Hospital Lluís Alcanyís, Xàtiva (Valencia), Spain.
Objective:
To assess the efficacy of hydrocolloid dressings in wound management after excision of pilonidal sinus.
Design:
Prospective randomised trial.
Setting:
District hospital, Spain.
Patients:
38 patients with chronic pilonidal sinus.
Interventions:
Open excision with healing by second intention. Divided into three groups: conventional gauze dressing (control, n = 15), Comfeel (n = 12) and Varihesive (n = 11).
Main Outcome Measures:
Median healing time, infection rate, intolerance, pain, comfort, ease of management, leakage, and recurrence.
Results:
Median healing time was 68 days (range 33-168) in the control group, compared with 65 days (range 40-137) in the two hydrocolloid groups combined. There were no differences between the hydrocolloid groups. There were no recurrences during the 74 months of follow-up. A third of the postoperative cultures in the control group grew pathogens compared with 1/23 of the patients treated with hydrocolloid dressings (p = 0.03). This was of no clinical relevance. 14/23 in the hydrocolloid group developed leaks. Pain was significantly less in the first four postoperative weeks among the patients in the hydrocolloid group than in the control group (p < 0.05).
Conclusions:
Hydrocolloid dressings lessen pain and increase comfort for patients after excision of pilonidal sinus, though time to healing is no shorten than when a conventional gauze dressing is used.