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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Published on: June 20, 2018

Excision with or without primary closure for pilonidal sinus disease.

Saleh M Al-Salamah¹, Muhammad Ibrar Hussain, Shaukat Mahmood Mirza

¹Department of General Surgery, King Saud University Unit, Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia.

JPMA. the Journal of the Pakistan Medical Association

|October 2, 2007

Summary

Excision with primary closure offers faster healing and return to work for chronic pilonidal sinus (PNS) disease compared to open wounds. Recurrence rates remain comparable between the two surgical methods.

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Area of Science:

Surgical Management
Colorectal Surgery
Wound Healing

Background:

Chronic pilonidal sinus disease (PNS) presents a significant management challenge.
Surgical intervention is the primary treatment modality for PNS.
The optimal surgical technique, specifically regarding wound closure, remains debated.

Purpose of the Study:

To compare the outcomes of excision with primary closure versus excision without closure for chronic PNS.
To evaluate key metrics including wound infection, healing time, time off work, and recurrence rates.

Main Methods:

A randomized trial involving 380 patients with chronic PNS disease was conducted.
Patients were assigned to either excision with midline closure (EMC) or excision without closure (EWC).
Exclusion criteria included patients presenting with acute pilonidal abscess.

Main Results:

The EMC group demonstrated significantly shorter hospital stays, mean healing times, and time off work compared to the EWC group.
Wound infection rates were 4.2% for EMC and 3.12% for EWC.
No statistically significant difference in recurrence rates was observed between the two groups (3.7% vs. 3%).

Conclusions:

Excision and primary closure (EMC) is recommended as a preferred method for managing chronic PNS disease.
EMC offers advantages of early wound healing and a faster return to work.
The recurrence rates are comparable to excision without closure (EWC).