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A Journal on Surgery

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Minerva Chirurgica 2003 April;58(2):181-8


language: Italian

Surgical treatment of pilonidal sinus with open surgical technique

Blanco G., Giordano M., Torelli I.


Background. Personal experience and results about the surgical treatment of pilonidal sinus using the open technique operation are reported.
Methods. Between January 1984 and June 2001, 577 patients (457 males and 120 females) underwent this surgical technique. Eighty-five patients presented recurrences of the under-lying disease previously treated with closed technique in other centres. In order to reduce the risks of recurrence, pilonidal sinus was widely resected in order to remove every fistulous track laterally or towards the anal edge. The surgical wound has to be wide, carefully drained, without vertical walls: the outer part of the wound should be wider than its bottom. The persistence of a hairless scar is a suitable result to avoid relapses.
Results. This surgical technique allowed very good results. Postsurgical morbility was not observed in these patients; the median time to achieve healing was 8±2 weeks. Furthermore, after a 3 year follow-up, only 4 patients (0.69%) relapsed. Recurrent dressings are needed; anyway they neither represent a limit of this technique nor lead to a long term absence from working. The postsurgical period of resting is quite similar to that usually prescribed after other surgical techniques and mainly depends on the patient nature. The treatment with connective tissue repairing drugs may be useful to obtain an effective healing.
Conclusions. In the authors' experience, the open surgical technique may obtain the definitive removal of pilonidal sinus, even if particularly wide, with a safe postsurgical course and a very hight percentage (99.31%) of complete healing without any relapse.

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