Morbidity and short term results in a randomised trial of open compared with closed treatment of chronic pilonidal sinus

Abstract

Objective: To evaluate the morbidity and short term results after open compared with closed treatment of chronic pilonidal sinus.

Design: Randomised control trial.

Subjects: 120 of 164 patients with chronic pilonidal sinus treated between April 1987 and April 1989.

Interventions: 60 patients were treated by excision and primary suture, and 60 by excision and open packing.

Main outcome measures: Incidence of early complications (bleeding that needed treatment, wound breakdown, infection, haematoma, or wound pain), number of postoperative visits required, and length of sick leave taken.

Results: Those patients who underwent excision and suture had slightly but not significantly fewer early complications (16/60, 27%, compared with 23/60, 38%). Most of the early complications were the result of infection (8, 13% compared with 18, 30%, respectively). They also required fewer followup visits and less sick leave, and their wounds healed more quickly. At one year the numbers of late complications were 19 (32%) and 14 (23%), respectively.

Conclusion: Excision and primary closure of chronic pilonidal sinus causes less morbidity and is more cost effective than excision and open packing. We plan a three year follow-up to see if these results are maintained.