Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable.

UNLABELLED: A chronically infected sacral wound requiring repeated shaving, cleansing and dressing after treatment of pilonidal sinus disrupts both work and social activity.

OBJECTIVE: To compare delay in pilonidal sinus wound healing after laying open with that after primary closure.

PATIENTS AND METHOD: Healing time and recurrence were recorded in a consecutive series of 102 patients in one hospital undergoing either asymmetric primary closure (Karydakis procedure) by a single surgeon or laying open by other surgeons.

RESULTS: The interval from operation to cessation of wound dressing was significantly shorter (log rank test, P < 0.0003) after primary closure (median 3 weeks, iqr 3-6) compared with laying open (median 6 weeks, iqr 4-8). No primary closure (0%) and 10 laid open (19%) wounds remained unhealed at 10 weeks from operation (2 × 2 contingency table, P = 0.003). No significant difference was demonstrated (Mann-Whitney U-test) between healing time in elective (median 3 weeks, iqr 3-6) compared with emergency (median 3 weeks, iqr 3-3) admissions treated by primary closure.

CONCLUSIONS: Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable.