Factors affecting the outcome and duration of healing of the laid open wound for sacrococcygeal pilonidal sinus: A prospective cohort study of 472 patients

Abstract

Objectives

Recent clinical reports showed excellent results when the lay open method was used for the treatment of chronic sacrococcygeal pilonidal sinus, despite keeping the wound open for a considerable time which increases the risk of infection, delayed closure, and recurrence. In this study, we aim to analyze the factors influencing the outcome of the laid open sacrococcygeal pilonidal wound regarding wound infection, complete wound closure, and recurrence.

Methods

A prospective cohort study of 472 patients with chronic sacrococcygeal pilonidal sinus who had the lay open procedure between January 2000 and December 2012 was done. 326 were male and 146 were female. Lay open was performed to all patients. Postoperative care and follow-up methods were similar in all patients. Preoperative, intraoperative, and postoperative factors affecting the outcome were analyzed.

Results

The mean age was 27.6 years. Male gender, smoking, BMI ≥ 30 kg/m², diabetes mellitus, the sinus number, wound depth of more than 3 cm, packing the wound, the cleaning material for wound irrigation, regular postoperative shaving of hair around the wound, postoperative complications mainly pus discharge from the wound, and poor postoperative body hygiene were the factors statistically found to represent a significant difference in association with longer wound healing time (P ≤ 0.01). The recurrence rate was 0% after four years of follow-up.

Conclusion

We concluded that many factors could affect the outcome of the laid open wound of the chronic sacrococcygeal pilonidal sinus. For the best outcome, careful consideration of these factors could help achieve an excellent result.