The results of a prospective randomized trial comparing wide excision with primary midline closure (group A) and wide excision with an open wound (group B) for chronic natal cleft pilonidal sinus carried over 5 years period on 43 consecutive out of total 52 patients are presented. The mean age was 23.7 years with male preponderance. Twenty-one (48.8%) patients gave history of sedentary habits whereas 17 (29.5%) patients were overweight. Seropurulent discharge from the sinus opening was the commonest presentation (93%) found in each group. Mean operative time for group A was 49 minutes and that for group B was 27 minutes (P>0.05). The mean healing time for group A was 14.5 days and for group B was 10 weeks (P<0.05). Overall wound failure was observed in 7% cases (1 group A and 2 group B patients). Total cost of treatment for group A (Rs. 4050/) was significantly lower (p<0.05) than that for group B (Rs. 6150/). Complete follow-up (mean 43 months) available on 38 (88.4%) patients revealed an overall 7.9% recurrence rate. There was no significant difference in morbidity and recurrence rate for the two procedures (P>0.05) whereas the total cost of treatment, healing time and time to return to gainful employment were significantly less for Group A (p<0.05). Excision with primary closure is recommended as the preferred, safe and cost-effective procedure for primary management of chronic natal cleft pilonidal sinus.
|Number of pages||4|
|Journal||Journal of the College of Physicians and Surgeons--Pakistan : JCPSP|
|Publication status||Published - 2001|
- Chronic disease
- Pilonidal sinus
- Wound healing