Comparative study between radiofrequency sinus excision and open excision in sacro-coccygeal pilonidal sinus disease

Evaluation of outcome of pilonidal sinus excision using a radiofrequency device and comparing its results with excision and open granulation procedure.

Patients with sacro-coccygeal pilonidal sinus disease (n=44) were randomly assigned to undergo either a wide excision and healing by open granulation procedure [WEG] (n=23) or a radiofrequency sinus excision [RSE] (n=21). An Ellman radiofrequency generator was used for RSE. Intra- and postoperative events and outcome data were evaluated and analyzed by Student's unpaired t test and chi(2) test.

The significant differences in the two groups WEG and RSE were as follows: mean hospital stay (47 vs. 10 h, p< 0.05), period off work (29 vs. 8 days, p< 0.05), mean analgesic requirement (39 vs. 15 tablets, p< 0.05), time for complete wound healing (84 vs. 49 days, p< 0.05). At the mean follow-up of 30 months, 2 patients from the wide excision and open granulation group and one patient from the radiofrequency sinus excision group developed recurrence.

These findings suggest that sinus excision with radiofrequency is a simple and swift procedure. It needs a short hospital stay and is associated with less postoperative pain and early resumption to work. As compared to excision and healing by granulation technique, the radiofrequency sinus excision procedure achieves faster wound healing and a better outcome.