Minimally Invasive Fibrin Sealant Application in Pilonidal Sinus: A Comparative Study

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Wound Healing

Background:

• Pilonidal sinus disease (PSD) is a common condition requiring effective treatment.
• Traditional management involves surgical excision and primary closure (PC), which can have drawbacks.
• Fibrin sealant (FS) presents a less invasive alternative for filling the sinus tract.

Purpose of the Study:

• To compare the efficacy and outcomes of fibrin sealant (FS) versus tract excision and primary closure (PC) for treating pilonidal sinus disease.
• To evaluate recurrence rates, infection rates, and need for further procedures between the two treatment groups.

Main Methods:

• A prospective study comparing 34 patients with symptomatic first-episode PSD treated with either FS (n=17) or PC (n=17).
• Patients were selected based on preference, excluding those with prior surgery or ongoing infection.
• Outcomes including recurrence, further procedures, outpatient visits, and follow-up duration were recorded.

Main Results:

• The fibrin sealant cohort experienced significantly fewer postoperative infections (1 vs. 8, p=0.045).
• Recurrence rates were similar between FS (5) and PC (4) groups (p=0.629).
• The FS group had a higher median number of sinuses treated (2 vs. 1, p=0.046).

Conclusions:

• Fibrin sealant is a viable and effective treatment option for pilonidal sinus disease.
• FS is not inferior to traditional excision and primary closure, offering a potential advantage in reducing postoperative infections.