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Is gentamicin-impregnated collagen sponge to be recommended in pilonidal sinus patient treated with marsupialization?
Background:
The ideal treatment method for pilonidal sinus has always been a matter of debate. Although primary closure or various flap applications offer shorter wound healing times, their infection rates are very high. Secondary recovery involves long recovery period. The aim of this study is to investigate the effects of gentamicin-impregnated collagen sponge on wound healing and infection in patients undergoing marsupialization.
Patients And Methods:
Fifty patients were included in the study. Twenty-five patients in control group (Group 1) underwent excision and marsupialization. Gentamicin-impregnated collagen sponge was used postoperatively in twentyfive patients in group 2. Three-dimensional wound measurements were made on the 0.7 and 15th days and recorded.
Results:
No significant difference was observed between the groups in terms of development of hemorrhage and infection. Excessive granulation was detected in five patients (two in group 1 and three in group 2). There was no significant difference between the groups with respect to this criterion. Full recovery times were 29.6 and 28.2 days respectively. No statistically significant difference was observed between the groups (p = 0.571). None of the patients developed recurrence at the end of the follow-up period of 6-30 months.
Conclusion:
In accordance with the results obtained in this randomized and controlled study, no significant difference was observed between gentamicin-impregnated collagen sponge group and control group with respect to development of infection, hemorrhage and wound healing times. Therefore, we do not recommend the use of gentamicin-impregnated collagen sponge after marsupialization.
Key Words:
Gentamicin-impregnated collagen sponge, Marsupialization, Pilonidal sinus.
Insights
Gentamicin-impregnated collagen sponge did not improve wound healing or reduce infection rates in patients undergoing marsupialization for pilonidal sinus. The study found no significant difference between the treatment and control groups.
Area of Science:
- Surgical Innovation
- Wound Management
- Infectious Disease Control
Background:
- Pilonidal sinus treatment remains debated, with primary closure and flap methods having high infection rates and secondary healing prolonged recovery.
- Marsupialization is a surgical technique for pilonidal sinus, but its outcomes require optimization.
- Investigating adjuncts to surgical procedures is crucial for improving patient recovery and reducing complications.
Purpose of the Study:
- To evaluate the efficacy of gentamicin-impregnated collagen sponge in enhancing wound healing and preventing infection after marsupialization for pilonidal sinus.
- To compare the outcomes of marsupialization with and without the use of gentamicin-impregnated collagen sponge.
Main Methods:
- A randomized controlled study included 50 patients with pilonidal sinus undergoing marsupialization.
- Patients were divided into two groups: a control group (n=25) and a group receiving a gentamicin-impregnated collagen sponge postoperatively (n=25).
- Three-dimensional wound measurements were taken on days 0, 7, and 15 to assess healing, alongside monitoring for infection, hemorrhage, and recurrence.
Main Results:
- No statistically significant differences were found between the groups regarding the incidence of hemorrhage and infection.
- Excessive granulation tissue occurred in a similar proportion of patients in both groups (2/25 vs. 3/25).
- Full recovery times were comparable, averaging 29.6 days for the control group and 28.2 days for the gentamicin-impregnated collagen sponge group (p=0.571).
Conclusions:
- The use of gentamicin-impregnated collagen sponge following marsupialization for pilonidal sinus does not offer significant advantages in terms of infection reduction or accelerated wound healing.
- Based on these findings, routine use of gentamicin-impregnated collagen sponge in this context is not recommended.
- Further research may explore alternative adjuncts or modifications to surgical techniques for pilonidal sinus management.
