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Risk factors for wound complication in pilonidal sinus procedures

Haitham Al-Khayat1, Hisham Al-Khayat, Adnan Sadeq

  • 1Department of Surgery, Saad Specialist Hospital, Al-Khobar, Saudi Arabia. halkhayat@yahoo.com

Journal of the American College of Surgeons
|September 4, 2007
PubMed

Insights

Pilonidal sinus surgery using excision and primary closure is effective for non-smokers and non-obese individuals. Obese patients and smokers face higher infection risks, necessitating interventions like weight loss or smoking cessation.

Area of Science:

  • Surgical outcomes and patient risk factors in pilonidal sinus disease.

Background:

  • Pilonidal disease frequently affects young individuals, leading to significant morbidity from chronic wounds and lifestyle limitations.
  • Complicated surgical wounds in pilonidal disease management result in prolonged recovery and reduced quality of life.

Purpose of the Study:

  • To evaluate the Karydakis procedure's efficacy in treating pilonidal sinus.
  • To identify risk factors contributing to infection and poor healing following pilonidal surgery.

Main Methods:

  • Retrospective review of 94 patients undergoing elective pilonidal sinus excision and primary closure over three years.
  • Analysis of wound healing, surgical site infections, and return to work.
  • Logistic regression used to identify predictors of surgical site infection and wound disruption.

Main Results:

  • Surgical site infection occurred in 12.8% of patients.
  • No recurrence was noted at a median follow-up of 6 months.
  • Smoking and obesity were identified as independent risk factors for developing wound infections (p=0.027 and p=0.047, respectively).

Conclusions:

  • Excision and primary closure is a viable treatment for non-obese, non-smoker patients with pilonidal sinus disease.
  • Obese patients and smokers exhibit high infection rates, suggesting preoperative weight loss, smoking cessation, or alternative surgical approaches.
  • Risk factor modification is crucial for improving surgical outcomes in pilonidal sinus treatment.
Abstract

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