Orifice Location Guided Excision and Flap Procedures for Treatment of Sacrococcygeal Pilonidal Disease

Abstract

Background. Although various surgical techniques have been described, there is no consensus on the optimal treatment for sacrococcygeal pilonidal disease (SPD). Objectives. The aim of this study is to report the medium-term results of three different surgical methods used to treat SPD that were chosen according to the localization of the sinus orifices. Material and Methods. Between November 2005 and April 2007, 43 patients with symptomatic SPD were treated by three different surgical methods. A classic approach, a modified flap technique and a new excision and flap technique were evaluated for treating SPD cases with different localizations of the sinus orifices. The study was carried out on the basis of retrospective reviews of patient charts and telephone interviews for prospective evaluation. Outcome measures included wound complications, time off work, complete healing time, paresthesia, recurrence rates and satisfaction with the procedures and outcomes. Results. There were no early postoperative complication among the 43 patients. The median hospitalization time was 6.76 days (2-12 days). The authors reached 31 patients (72.09%) by phone for the interview; the median follow-up time was 48.41 months (range 42-59 months). No recurrences were reported. The median time off work and complete healing time were 20.54 and 18.61 days, respectively. All but three of the patients reported satisfaction with the esthetic outcome. All the patients reported satisfaction with the effectiveness of the surgical approaches used. One patient reported dissatisfaction with the anesthesia technique. There were complaints of paresthesia from eight patients (one severe, seven moderate). All the patients said that they would recommend these operations and anesthesia techniques to relatives or other patients with sacrococcygeal pilonidal disease. Conclusions. Different excision and flap methods should be used to treat cases of sacrococcygeal pilonidal disease with different localizations of the sinus orifices (Adv Clin Exp Med 2011, 2011, 4, 481-488).