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Modified off-midline closure of pilonidal sinus disease.

Aly Saber1

  • 1Department of General Surgery, Port-Fouad General Hospital, Port-Fouad, Port-Said, Egypt.

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A simplified off-midline closure technique for pilonidal sinus disease offers outcomes comparable to traditional flap methods. This approach may reduce surgery complexity and time while improving cosmetic results for patients.

Keywords:
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Area of Science:

  • Surgical innovation in proctology and general surgery.
  • Minimally invasive surgical techniques.
  • Patient outcomes in chronic disease management.

Background:

  • Pilonidal sinus disease (PSD) presents frequent treatment challenges with high recurrence rates.
  • Conventional off-midline flap closures for PSD offer good surgical outcomes but often result in poor cosmetic results.

Purpose of the Study:

  • To evaluate the outcomes of a novel, simplified off-midline technique for closing defects after pilonidal sinus excision.
  • To assess the efficacy and safety of this simplified closure method compared to conventional techniques.

Main Methods:

  • A modified D-shaped excision technique was employed in 200 patients (both sexes) to ensure complete removal of sinus tracts.
  • A simplified off-midline closure procedure was utilized to manage the surgical defect.

Main Results:

  • The study reported an overall wound infection rate of 12% and a wound disruption rate of 6%.
  • The overall recurrence rate for pilonidal sinus disease was 7% in the study cohort.
  • Specific rates for males and females were comparable, indicating consistent outcomes across genders.

Conclusions:

  • The simplified off-midline closure technique demonstrates comparable efficacy to conventional flap closures regarding infection, dehiscence, and recurrence.
  • This simplified method offers potential advantages including reduced surgical complexity, shorter operation times, and enhanced cosmetic outcomes for pilonidal sinus disease patients.