Sinus pilonidalis-elastic ligature as an optimal outpatient treatment

The incidence of pilonidal sinus shows a steadily rising tendency, especially in the patient age group of up to 40 years. Treatment of this condition is often protracted involving lengthy sick leave and an increased risk of recurrence. The optimal treatment of pilonidal sinus remains open to debate, but it should focus on decreasing the length of hospitalization, promoting a rapid return to daily life, maintaining low pain levels, and keeping costs at a minimum.

In our study conducted between 2017 and 2021, we focused on treatment of pilonidal sinus. We performed 50 elastic ligature procedures with a median observation time of 30 months. The patients were divided into three groups according to the characteristics of pilonidal sinus: (1) acute primary abscess; (2) acute recurrent abscess; and (3) chronic fistula.

Out of a total of 50 patients with a subsequent 30-month follow-up, we observed complete recovery in 47 patients and recurrence in three patients. Return to work was possible immediately after the operation, with an average total treatment time of 1 month for complete healing of the defect.

The current results suggest that the technique of elastic ligature is a desirable solution for pilonidal sinus, because of the initial low costs, no need for hospitalization, and good patient tolerance.