OUTCOME OF OPEN VERSUS CLOSED SURGICAL TECHNIQUE FOR TREATMENT OF CHRONIC PILONIDAL SINUS: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVE: To compare the outcome of “excision with leaving open” versus “excision with primary closure” of chronic pilonidal sinus (PNS) of saccrococygeal area in terms of hospital stay, wound healing, return to work and postoperative complications.METHODOLOGY: This study was conducted at surgical unit Divisional Headquarter Hospital Kohat, Pakistan during the period April 2007 to April 2009. Thirty confirmed cases of chronic PNS were included in the study. Patients were randomly assigned to two groups i.e. group-A (excision with leaving open) group-B (excision with primary closure).Data was collected prospectively on structured proforma. Patients were regularly followed up for 2 years for complications. Statistical analysis was done by using SPSS version 14.RESULTS: Out of 30 patients, 26 (86.7%) were males and 4 (13.3%) were females with mean age of 28.47+/-9.75 years. Group-A included 16 (53.30%) patients while Group-B included 14(46.70%) patients. The patients in group-B had shorter hospital stay (3.5+ 0.6504 vs. 4.7+0.5774 days, p 0.01), faster recovery (2.78+0.6993 vs. 7.15+1.0602 weeks, p 0.01) and earlier return to work (16.42+5.4591 vs. 29 + 3.7238 days, p 0.01). No significant difference was found in both the groups in terms of short and long term postoperative complications. Wound Infection (n=5/30; 16.7%) and itching 5 (n=5/30; 16.7%) were the commonest short term complication while recurrence (n=3/30; 10%) and hypertrophic scar (n=3/30; 10%) were the commonest long term complications. CONCLUSION: Closed method was found to be better than open method in chronic pilonidal sinus in terms of recovery, hospital stay and time of work.