COMPARISON OF PRIMARY CLOSURE AND RHOMBOİD FLAP TRANSPOSITION TECHNIQUES IN THE TREATMENT OF PILONIDAL SINUS DISEASE
Dr. Gül DAĞLAR, Dr. Y. Nadi YÜKSEK, Dr. Uğur GÖZALAN, Dr. Murat AKGÜL, Dr. Nuri Aydın KAMA
4. Cerrahi Kliniği Ankara Numune Eğitim ve Araştırma Hastanesi
In the surgical treatment of chronic pilonidal sinus disease, primary closure and rhomboid flap transposition techniques were compared according to the early complications and recurrence rates. There are various operative techniques in the management of pilonidal sinus disease. Recurrence rates are high regardless from the operative technique. Flap transposition techniques have not proven to be superior to the primary closure. Sixty-nine patients were evaluated prospectively. All patients were primary cases and were divided into two groups in a randomized manner. In group A primary closure and in group B rhomboid flap transposition techniques were used. Student's t test (for the hospital stay and drainage time) and chi-squared test (for early complications and recurrence rates) were used to determine the statistical difference.
There were no statistically significant difference between the groups according to duration of the hospitalization period, duration of the wound healing, and average follow up period (p>0,05). Postoperative early complication rate was significantly higher in group A (p<0,05) and recurrence rate was significantly higher in group B (p<0,05). Usage of drain, mean drainage period and the need for general anesthesia were significantly higher in group B (p<0,05). The choice of treatment in the surgical management of pilonidal sinus should be simple, comfortable for the patient and have a low recurrence rate. There was less need of drain usage and general anesthesia in the patients underwent excision with primary closure without recurrence in the follow up period. In addition to the advantages mentioned above, primary closure is a simple technique. As a conclusion we suggest the primary closure technique as a choice of procedure in the management of pilonidal sinus disease.
Keywords: Pilonidal sinus disease, primary closure, rhomboid flap transposition.