Does pilonidal abscess heal quicker with off-midline incision and drainage?

Area of Science:

• Surgical Outcomes
• Wound Healing
• Infectious Disease Management

Background:

• Optimal surgical technique for pilonidal abscess drainage remains undefined.
• Lack of clinical trials guiding surgeons on incision placement for pilonidal abscesses.

Purpose of the Study:

• To investigate the influence of incision location (midline vs. lateral) on wound healing time after pilonidal abscess drainage.

Main Methods:

• Retrospective review of 243 patients undergoing incision and drainage for acute pilonidal abscess (Jan 2003-Feb 2010).
• Comparison of wound healing times between patients receiving midline versus lateral incisions.
• Matching of midline and lateral drainage groups based on gender, age, and microbiology.

Main Results:

• Lateral incisions (n=134) resulted in faster wound healing compared to midline incisions (n=74).
• Midline drainage associated with approximately 3 weeks longer healing time (P=0.02).
• No significant difference in follow-up duration or time to healing for non-healed abscesses based on incision type.

Conclusions:

• Pilonidal abscesses should be drained using a lateral incision, away from the midline.
• Lateral drainage appears to be a more effective surgical approach for pilonidal abscesses.