Abstract

Objective: In pilonidal sinus surgery many surgical techniques have been described these days because of very frequent occurrence of wound detachment and recurrences. In this study, in the light of the literature, discussion of the results of the surgical treatment was intended in cases with complicated pilonidal sinus.

Material and Methods: All hospital records of the cases operated with the diagnosis of complicated pilonidal sinus in our clinic between June 2010 and June 2014 were examined. Demographic characteristics of the patients, the surgical methods and the results of surgery were analyzed.

Results: Eighteen cases [7 (39 %) adolescent boys, and 11 (61 %) girls] had been operated for complicated pilonidal sinus in our clinic within 4 years. Mean age of the patients was 14.7 years (min. 11-max. 17 years) at the time of the operation. The mean body weight (81.5 kg) of males was higher than the mean weight of females (68.5 kg). Percentiles based on body weight of males were slightly higher than those of females. The average body weight of the girls were found to be significantly higher than that of males. Excision of the complicated pilonidal sinus was performed in 7 cases (41 %) with Karydakis method and in 11 cases (59 %) with Limberg flap method by suspending the corners of the lesion with the principle of non-touch method. One case operated at another center one year ago was operated in our clinic because of recurrence. The mean duration of postoperative hospitalization was 3 days. The patients were treated with oral antibiotic therapy using cefazolin and metronidazole, and for a period of two weeks, mobilization of the patients was restricted, and medical dressing was applied Sutures were taken at postoperative 3rd weeks. Follows-up of all cases were uneventful. Wound infection was seen in one case (5.5 %) and recurrence happened in another case (5.5 %).

Conclusion: Suspending the incision corners with sutures and holding wound edges gently with fine-toothed forceps are thought to accelerate wound healing, and to reduce the wound infection and detachment in the pilonidal sinus surgery. Indeed, relapse rates in our patients who underwent surgery for complicated pilonidal sinus using two different methods by non-touch principle were found to be very low compared to the relapse rates cited in the literature.