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. 2011 Apr;54(2):78-82.
doi: 10.1503/cjs.026309.

Ambulatory treatment of chronic pilonidal sinuses with lateral incision and primary suture

Hemmat Maghsoudi  1 , Nariman Nezami, Ali Akbar Ghamari
Affiliations

Ambulatory treatment of chronic pilonidal sinuses with lateral incision and primary suture

Hemmat Maghsoudi et al. Can J Surg. 2011 Apr.

Abstract
in English, French

Background: Outpatient management is appropriate for chronic pilonidal sinuses. Even though there are different surgical treatments for pilonidal sinuses, the outcome may not be uniformly satisfactory. The aim of this paper was to examine the ambulatory treatment of chronic pilonidal sinuses with lateral incision and primary suture.

Methods: We present our experience with outpatient management of asymptomatic chronic pilonidal disease. We prospectively studied patients presenting with pilonidal disease from Mar. 20, 2005, to Mar. 20, 2008. All were managed as outpatients. We reviewed presentation, treatment, healing, time off work and recurrences.

Results: In all, 150 patients (131 men and 19 women) with chronic pilonidal sinuses underwent ambulatory plain lateral excision and primary repair during the study period. The mean age of patients was 22.1 years. The mean duration of surgery was 18.4 minutes. No general complications occurred. Local complications consisted of 3 wound infections and 4 wound hematomas. No sinus recurrence occurred. The healing rate was fast in all patients.

Conclusion: Advantages of ambulatory plain lateral excision and primary repair include immediate treatment, minimal pain and a quick return to normal activities. This method is a simple and effective procedure in the treatment of uncomplicated pilonidal sinuses.

Contexte: La prise en charge en service externe convient dans le cas de sinus pilonidaux chroniques. Même s’il existe divers traitements chirurgicaux pour les sinus pilonidaux, le résultat peut ne pas être uniformément satisfaisant. Cette communication visait à examiner le traitement ambulatoire des sinus pilonidaux chroniques par incision latérale et suture immédiate.

Méthodes: Nous présentons notre expérience de la prise en charge en service externe de la maladie pilonidale chronique asymptomatique. Nous avons étudié de façon prospective les patients qui se sont présentés avec une maladie pilonidale du 20 mars 2005 au 20 mars 2008. Tous ont été traités en service externe. Nous avons passé en revue la présentation, le traitement, la guérison, l’absence du travail et les récidives.

Résultats: Au total, 150 patients (131 hommes et 19 femmes) qui avaient des sinus pilonidaux chroniques ont subi une excision latérale ordinaire et une réparation immédiate en service ambulatoire au cours de la période à l’étude. Les patients avaient en moyenne 22,1 ans. L’intervention chirurgicale a duré en moyenne 18,4 minutes. Il n’y a pas eu de complications généralisées. Il y a eu 3 plaies infectées et 4 hématomes à la plaie comme complications locales. Le sinus n’est pas réapparu. La guérison a été rapide chez tous les patients.

Conclusion: Les avantages de l’excision latérale ordinaire et de la réparation immédiate en service ambulatoire comprennent le traitement immédiat, une douleur minimale et la reprise rapide des activités normales. Cette méthode est simple et efficace pour traiter les sinus pilonidaux sans complication.

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Figures

Fig. 1
Fig. 1
Local anesthetic: 8 mL of a 2% solution of lidocaine and 2 mL of a 0.25% solution of bupivacaine was injected into the sinus area.
Fig. 2
Fig. 2
Lateral incision and removal of sinus tract.
Fig. 3
Fig. 3
Residual cavity after removal of the pilonidal sinus.
Fig. 4
Fig. 4
Skin sutures were made and sinus pits débrided and left open for drainage.
Fig. 5
Fig. 5
Age distribution of patients with pilonidal sinus disease.
See this image and copyright information in PMC

References

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