Šmíd D., Novák P., Liška V., Třeška V.: Pilonidal Sinus – Surgical Management at Our Surgical Clinic

Česká verzia

Authors: D. Šmíd; P. Novák; V. Liška; V. Třeška
Authors place of work: Chirurgická klinika FN a LF UK v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in the journal: Rozhl. Chir., 2011, roč. 90, č. 5, s. 301-305.
Category: Monothematic special - Original

Summary

Introduction:
pilonidal sinus disease is a benign disease with incidence 26 cases per 100 thousands inhabitants each year. The origin of this disease is in sacrococcygeal region with maximum between 15th and 25th year of life. Males suffer from pilonidal sinus disease most often. The synonym of this disease is Jeep’s disease and originate in Second World War. We distinguish acute and chronic phase of this disease. The acute phase is characterized by presence of abscess whereas the chronic phase is featured by intermittently secreting fistula. Malignant reversion is described at chronic phase in 0.1%.

Methods:
We performed retrospective study of our cohort of 53 patients that undewent radical surgical treatment at our department between September 1st 2006 and December 31st 2009.

Results:
We evaluated 39 patients that were controlled repetitively after operation. Males were in majority. The median of age was 24 years. 38 patients underwent the incision for abscess in preoperative period. The intermittently secreting fistula was diagnosed at 46 patients at the time of operation. 41% patients suffered from wound infections and 56% from dehiscence of wound (7 patients with partial dehiscence) after radical excision. We used 5 modifications of wound closure after radical excision.

Discussion:
The choice of adequate method of wound closure after excision of pilonidal sinus was, is and will be discussed among experts. We could find many types of methods of wound closure including plastic with flaps in the scientific literature. In our country there is preferred more primary wound closure than plastic with flap. Our results are comparable with the previously published results.

Conclusion:
The treatment of pilonidal sinus has to be radical. We can conclude that usage of our technique of underlaid sutures decreases the prevalence of postoperative infection and risk of wound dehiscence. The proper types of technique of wound closure could not be evaluated with statistical signifikance because of small number of patients in our kohort.

Key words:
pilonidal disease – surgical treatment – closed excision

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