Do we need to use subcutaneous suture for pilonidal sinus treated with excision and simple primary closure?

Pilonidal sinus (PS) is a chronic intermittent disease. There are numerous surgical treatment procedures that have been previously reported, yet none have been proved to be ideal. The main issues concerning the surgical treatment of PS are simplicity and cost-effectiveness. This study is designed to research the possibility of decreasing operation costs in the excision and simple primary closure technique of PS by omitting subcutaneous suture usage.

152 male patients with chronic PS were included in the study. All patients were treated with excision and simple primary closure technique and randomized into two groups. Group-I (n = 74) received subcutaneous closure with 2/0 polyglactin sutures, but Group-II (n = 78) did not. Wound edges were re-approximated by using deep interrupted matress 0 no polypropylene sutures in both groups.

In Group-I; overall 7 (9.5%) early complications were noted; 2(2.7%) wounds broke down and 5 (6.7%) experienced superficial wound infections. Any late wound complications were noted. A total of 98 polypropylene and 104 polyglactin sutures were used. In Group-II; overall 5 (6.4%) early wound complications were noted; 3 (3.8%) had wound dehiscence and 2 (2.6%) developed superficial wound infections. Also, 1 (1.3%) late wound complication (wound dehiscence) occurred. Overall 104 polypropylene sutures were used.

Excision and simple primary closure is a simple and cost effective surgical procedure in the treatment of PS. Omitting the use of subcutaneous sutures makes the procedure simpler and decreases the operation costs.