Outpatient pilonidal sinotomy complemented with good wound and surrounding skin care

OBJECTIVE: To describe an improved method for treating pilonidal sinus disease.

METHODS: An outpatient procedure involves laying the pilonidal sinus tract open under local anesthesia, removal of hair and debris, curettage of granulation tissue, with subsequent daily dressing, weekly shaving, and let it heal by secondary intention. The medical records of 100 patients underwent this procedure were studied regarding complications, healing time, and recurrence. This study was carried out at King Abdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia, between January 2000 and December 2003.

RESULTS: Ninety-five patients (95%) were males and 5 patients (5%) were females. The mean age was 21.7 years. Almost all patients who underwent the procedure were discharged after the procedure. Complications included 2 cases (2%) of bleeding, one case (1%) of vasovagal attack requiring admission overnight, 10 cases (10%) of delayed healing, and 2 cases (2%) of recurrence after an average of one year from complete wound healing. Ninety patients (90%) had completed healing after one month of daily dressing and 10 patients (10%) after 2 months.

CONCLUSION: Outpatient pilonidal sinotomy with good wound and surrounding skin care is an ideal approach with high chance of cure.