Primary closure method after asymmetrical excision of a pilonidal sinus treatment: A retrospective cohort study

Abstract

Background/Aim: There is no gold standard method in pilonidal sinus surgery, because each technique has a recurrence rate. This study aims to evaluate the outcomes of pilonidal sinus surgeries performed by a single surgeon using excision and primary closure technique in a state hospital. Methods: The study included 159 pilonidal sinus patients operated on by a single surgeon in the General Surgery Department between September 2014 and May 2022. The patients were investigated retrospectively, and age, gender, surgical technique, type of anesthesia administered, time needed to return to normal life, history of previous abscess drainage, long-term complaints in the incision area, number of intergluteal sinuses, postoperative complications and recurrence rates were recorded. Missing information was completed with polyclinic medical records and phone calls. Patients with incomplete data were excluded from the study. An excision and primary closure method was performed on all patients included in the study. Results: Sixty-seven (42.1%) of the patients were male and 92 (57.9%) were female. The mean age was 27.8 (8.97) years. Twenty-one (13.2%) patients were operated on under local anesthesia, whereas 138 (86.8%) received spinal anesthesia. The mean operative time was 28.87 (8.01) minutes (range: 14-47 minutes). The mean length of hospital stay was determined to be one day (range: 6-24 hours). Surgical-site infections developed in 4 (2.5%) patients and wound dehiscence developed in 14 (8.8%) patients during the postoperative period. Patients developing these conditions were followed up with dressing and antibiotic treatment. The mean postoperative follow-up period was 67 months (range: 1-105 months). Recurrence was detected in six patients during the follow-up period, representing a recurrence rate of 3.8%. Conclusion: Primary closure after asymmetrical excision of the pilonidal sinus is an easily performed technique with minimal postoperative pain and early wound healing. Additionally, this method has early return-to-work rates and low recurrence rates. We think that this method would be more applicable in pilonidal sinus surgery due to these advantages.