Comparison of Two Surgical Methods, Primary Closure and Rotational Flap, in Patients With Chronic Pilonidal Sinus

INTRODUCTION: Pilonidal sinus is a common infectious process which occurs in buttocks and sacral area which involves a wide range of symptoms that are different from an asymptomatic sinus abscess to acute and chronic sinus track. Basically non-surgical treatment for this disease is not recommended. In this study, we have been compared two methods of primary repair and rotation flap in terms of factors such as duration of hospitalization, recurrence, infection etc. METHODS: 80 patients with chronic pilonidal sinus were randomly divided into two groups and underwent surgery. Diabetic and obese patients with underlying diseases and patients with acute pilonidal abscess or prior surgery were excluded. The patients’ hospital stay, duration of postoperative pain, itching and hematoma, were investigated. RESULTS: In this study, patients’ sex and mean age were examined in terms of frequency of complications of hematoma, wound infection, recurrence, itching, and duration of hospitalization and the presence of seroma, there is no significant difference between the two methods of primary surgical repair and rotation flap (P>0.05) But in terms of the opening of the surgical wound, in primary surgical method, 5 patients (12.5%), wound dehiscence were reported, in rotation flap, any case of wound dehiscence were reported. There is significant difference between wound dehiscence in patients with chronic pilonidal sinus and two methods of surgery. (P=0.02). The mean duration of pain relief was 15.2±3.35 days in the primary surgical repair method and rotation flap was 7±2.3 days. According to the test there is significant difference between mean duration of pain relief and two surgical methods. (P=0.001). The mean duration of sutures was 15.3±2.3 days in the primary repair method and in rotational flap was 12±3.6 days. There is significant difference between the mean duration of sutures and two surgical methods (P=0.001) CONCLUSION: Considering these results, rotational flap is the preferred method due to fewer complications, lower recurrence after surgery and faster healing time of surgical wounds and as a result, the effective force’s early return to economic cycle. Finally, we can say that each surgeon according to the type and size of the sinuses and occupational status and social class, personality and individuality of the patient can select the appropriate method of surgery.