The new technique for radical treatment of the pilonidal sinus

Objective of the study is to improve treatment results and reduce the number of postoperative complications in patients with pilonidal sinus.

Material and methods. A comparative analysis of the treatment results in 60 patients divided into three comparable clinical observation groups was performed. In the 1st group (main group), the new developed two-stage method was used (RF patent № 2770283). In the 2nd group, the «cleft lift» procedure was applied. Wide excision of fistulous passages and closure of the postoperative defect without using the «cleft lift» procedure were carried out in patients of the 3rd group.

Results. In patients of the 1st group, the postoperative period proceeded more smoothly. The frequency of wound suppuration was minimal in comparison with other patient groups - 2 cases (10%). There were no significant infiltration-inflammatory complications in patients treated by the new method. In the 2nd group, the suppuration of the wound occurred in 4 patients (20%), in one case (10%) a recurrent fistulous passage was formed, in 2 patients (10%) prolonged resorption of infiltrates which required drainage and sanation of the wound occurred. There were recurrences in 10% of the patients. In the 3rd group, the total proportion of relapses was 15%, the total proportion of postoperative complications amounted to 45%. The duration of treatment in the 1st group was reliably less (4,6±1,3 days) as well as the period of temporary incapacity for work (9,7±1,3 days) in case of smooth course, and in case of wound suppuration it was 15±1 days in comparison with the control groups data.

Conclusions. The developed method of two-stage surgical treatment of pilonidal sinus makes it possible to increase the efficiency of surgical treatment, decrease the number of recurrences and complications, and reduce the period of temporary incapacity for work.

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