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Treatment of chronic pilonidal sinus with local anaesthesia: a randomized trial of closed compared with open
M Testini1, G Piccinni, S Miniello
1Section of General Surgery, Vascular Surgery and Clinical Oncology, Department of Applications in Surgery of Innovative Technologies, University of Bari School of Medicine, Bari, Italy. mario.testini@tin.it
Objective:
To compare open with closed treatment of chronic pilonidal sinus.
Patients And Methods:
From 1993 to 1996, 100 patients were submitted to excision of chronic pilonidal sinus, with local anaesthesia and were randomized in two groups: group A in which open treatment and group B in which direct suture were performed. The follow-up, ranging from 37 to 89 months, was performed by outpatient visits or by phone.
Results:
Short-term results showed 6 (12.0%) post-operative complications in group A vs 10 (20.0%) in group B. Long-term results showed 9 (18.0%) complications in group A vs 7 (14.0%) in group B. Mean wound healing was 58 days (range: 29-93) in group A vs 12 (range: 9-61) in group B. The return to normal activity was 25.7 (range: 11-77) vs 10.4 (range: 5-32). Wound healing and the return to normal activity were the only statistically significant differences.
Conclusions:
Regarding morbidity neither technique has particular advantages over the other. The closed technique produced quicker wound healing and a quicker return to normal activity.