Modified Primary Closure Method for the Treatment of Pilonidal Sinus

Area of Science:

• Surgical Oncology
• General Surgery
• Wound Healing

Background:

• Pilonidal sinus (PS) is a common acquired sacrococcygeal disease.
• Current surgical treatments for PS lack a universally accepted standard.
• Various methods exist, including excision with different closure techniques.

Purpose of the Study:

• To compare the efficacy of total sinus excision with primary closure versus modified primary closure (MPC) for PS treatment.
• To evaluate complication rates, recurrence, and other outcomes between the two surgical methods.

Main Methods:

• A retrospective study of 98 patients undergoing PS surgery between January 2012 and August 2014.
• Patients were divided into two groups: total sinus excision with primary closure (Group 1) and total sinus excision with modified primary closure (MPC) (Group 2).
• Key outcomes assessed included operation duration, excised skin area, hospital stay, wound dehiscence, recurrence, and general complications.

Main Results:

• The MPC group (54 patients) showed statistically significant reductions in wound dehiscence, recurrence, and general complications compared to the primary closure group (44 patients).
• Multivariate analysis indicated that primary closure increased complication rates 6.65 times, while MPC increased operation duration by 1.2 times.
• Mean operation duration was 39.1 min for primary closure and 52.2 min for MPC; excised skin area was 9.3 cm² vs. 2.6 cm² respectively.

Conclusions:

• The modified primary closure (MPC) method is a promising alternative for surgical treatment of pilonidal sinus.
• MPC demonstrates a lower incidence of complications and recurrence rates.
• Further investigation into MPC for pilonidal sinus management is warranted.