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Phenol Injection Versus Excision With Open Healing in Pilonidal Disease: A Prospective Randomized Trial
Ismail Calikoglu1, Kamil Gulpinar, Derya Oztuna
11 Department of Surgery, Ankara University, Ankara, Turkey 2 Department of Surgery, Ufuk University, Ankara, Turkey 3 Department of Biostatistics, Ankara University, Ankara, Turkey 4 Department of Surgery, Konya Training and Research Hospital, Konya, Turkey.
Diseases of the Colon and Rectum
|January 7, 2017
Summary
Phenol injection offers faster wound healing and quicker return to daily activities compared to surgical excision for pilonidal disease. Both treatments show similar long-term recurrence rates.
Area of Science:
- Surgical Innovation
- Minimally Invasive Procedures
- Proctology
Background:
- Pilonidal disease management often involves surgical excision.
- Minimally invasive techniques are being explored as alternatives.
- Phenol injection presents a less invasive treatment option.
Purpose of the Study:
- To compare the efficacy and outcomes of phenol injection versus excision with open healing for pilonidal disease.
- To evaluate key clinical endpoints including healing time, pain, and patient-reported outcomes.
Main Methods:
- A prospective randomized study (ACTRN12612000868886) was conducted.
- 140 patients were randomized to either phenol injection (n=70) or excision with open healing (n=70).
- Outcomes assessed included time to wound healing, pain scores, painkiller use, return to daily activities, recurrence rates, and quality of life surveys.
Main Results:
- Phenol injection resulted in significantly faster complete wound healing (16.2 days vs. 40.1 days) and shorter operation times (14 min vs. 49 min).
- Patients receiving phenol injection experienced quicker return to daily activities and reported lower pain scores and reduced painkiller intake within 48 hours.
- No significant difference in recurrence rates was observed between the two groups at a mean follow-up of 39.2 months.
Conclusions:
- Phenol injection is an effective treatment for pilonidal disease, comparable to excision with open healing.
- The minimally invasive approach offers advantages in terms of faster healing and reduced patient discomfort.
- Limitations include the lack of double-blinding and a higher history of abscess drainage in the surgery group.
