Vacuum-assisted closure in secondary wound healing after pilonidal sinus surgery

This study evaluated the utility of vacuum-assisted closure (VAC) in comparison to standard open wound care in patients operated for pilonidal sinus disease (PSD).

Patients with PSD who underwent standard pilonidal sinus excision-lay open technique/surgery in the Altınbas University School of Medicine Bahcelievler Medical Park Hospital, Istanbul, Turkey, between May 2015 and May 2018, were included in this study. A retrospective analysis of prospectively collected data was performed. The patients were divided into two groups according to the type of wound care, including the vacuum-assisted closure group (n=30, postoperative vacuum-assisted closure application) and the control group (n=30, standard open wound care). Wound size, postoperative infection rates and wound healing times were compared between study groups.

The experimental cohort included 60 patients. There was no statistically significant difference between vacuum-assisted closure and the control groups in terms of preoperative and postoperative infection rates (p>0.05). The total recovery time (time to complete wound healing) was significantly shorter in the vacuum-assisted closure group compared with the control group (21.47±4.38 days versus 67.60±7.83 days, p=0.001).

The findings of this study emphasise that the use of vacuum-assisted closure in PSD patients treated with the lay-open technique seems notable in terms of its potential to shorten the otherwise longer secondary recovery time and thus enables the consideration of the lay-open technique once again among the most preferable methods. However, there is a need for larger scale prospective studies addressing the utility of vacuum-assisted closure in patients with PSD to validate these findings.