Background
Surgical intervention for pilonidal sinus is associated with an increased risk of wound complications and recurrence. The therapeutic method of pilonidal abscess with delayed closure surgery was compared with initial cyst excision in patients with acute pilonidal cysts.
Methods
This randomised, double-blind clinical trial included 202 patients with acute pilonidal abscess. Demographic data, age, gender, and body mass index, and patient symptoms were recorded. Participants were then randomly assigned to either Group A or Group B. Group A underwent drainage and cyst excision during a single surgical procedure. Group B underwent incision and drainage of the abscess, followed by discharge with an antibiotic prescription; delayed cyst excision was performed 1 month later. Post-operative outcomes assessed included hematoma, cellulitis, seroma, infection, wound dehiscence, and treatment cost.
Results
No significant differences were observed between the two surgical groups with respect to age, gender, body mass index, wound characteristics, or post-operative discharge (P > .05). Seroma formation was not observed in any patient in either group. Moreover, there were no significant differences between the two groups in the incidence of cellulitis, infection, or hematoma after surgery (P > .05). However, wound dehiscence occurred significantly more frequently in Group A than in Group B (13% vs 3%, P = .009). The cost of treatment was similar between the two groups (P = .100).
Conclusion
Given the higher incidence of wound dehiscence and longer operative time observed with initial surgery, delayed closure surgery appears to be the preferable approach for the treatment of acute pilonidal abscess.
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