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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
Summary
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.
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