Current trends in the management of pilonidal sinus disease and its outcome in a periphery hospital

Fauwaz Fahad Alrashid; Saadeldin Ahmed Idris; Abdul Ghani Qureshi; Fauwaz Fahad Alrashid; Saadeldin Ahmed Idris; Abdul Ghani Qureshi

doi:10.3934/medsci.2021008

AIMS Medical Science

2021, Volume 8, Issue 1: 70-79. doi: 10.3934/medsci.2021008

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Research article

Current trends in the management of pilonidal sinus disease and its outcome in a periphery hospital

1.
Department of Surgery, College of Medicine, University of Hail, KSA
2.
Department of Surgery, Almikhwah General Hospital, Al-Baha, KSA

Received: 08 December 2020 Accepted: 02 March 2021 Published: 09 March 2021

Background
The attention of surgeons to pilonidal sinus disease is increasing. We aimed to estimate the incidence of Pilonidal sinus disease, and verify the employed management and its outcome in term of surgical site infection, recurrence and patients' satisfaction.
Methods
A cohort study included 224 patients with pilonidal sinus disease (Jan 2014 to April 2020).
Results
Mean age was 23.83 ± 4.9 years, with male predominance (male to female ratio of 2.25:1). Incidence of pilonidal sinus disease was 2.9% of all surgical clinic population. Mean duration of symptoms was 65.8 ± 50.7 days. Majority (80.8%) had chronic pilonidal sinus, whereas the remainder 19.2% had acute onset with abscess. In pilonidal sinus the surgical modality was fashioned according to the extent of the disease keeping in mind the number of sinus opening in form of Limberg flap (44.2%), primary closure (19.6%), or laid open to heal by secondary intention (17%). Recurrence of pilonidal sinus was seen in 2.2% and not affected by the procedure employed (P = 0.4). Whereas, in cases of pilonidal abscess the recurrence rate was 27.9%. The difference was significant (p = 0.00001). Over all patients' satisfaction was very good/excellent in 187 (83.4%).
Conclusions
To reduce congestion of the operating lists in central hospitals, one can use a clear criterion based on the extent of the disease and the number of sinus openings, this will facilitate the management of pilonidal sinus disease in peripheral hospital settings, and comparable results can be achieved in terms of recurrence rate and patient satisfaction.
- patients' satisfaction,
- pilonidal abscess,
- pilonidal disease,
- pilonidal sinus,
- surgery
Citation: Fauwaz Fahad Alrashid, Saadeldin Ahmed Idris, Abdul Ghani Qureshi. Current trends in the management of pilonidal sinus disease and its outcome in a periphery hospital[J]. AIMS Medical Science, 2021, 8(1): 70-79. doi: 10.3934/medsci.2021008

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Abstract

Background

The attention of surgeons to pilonidal sinus disease is increasing. We aimed to estimate the incidence of Pilonidal sinus disease, and verify the employed management and its outcome in term of surgical site infection, recurrence and patients' satisfaction.

Methods

A cohort study included 224 patients with pilonidal sinus disease (Jan 2014 to April 2020).

Results

Mean age was 23.83 ± 4.9 years, with male predominance (male to female ratio of 2.25:1). Incidence of pilonidal sinus disease was 2.9% of all surgical clinic population. Mean duration of symptoms was 65.8 ± 50.7 days. Majority (80.8%) had chronic pilonidal sinus, whereas the remainder 19.2% had acute onset with abscess. In pilonidal sinus the surgical modality was fashioned according to the extent of the disease keeping in mind the number of sinus opening in form of Limberg flap (44.2%), primary closure (19.6%), or laid open to heal by secondary intention (17%). Recurrence of pilonidal sinus was seen in 2.2% and not affected by the procedure employed (P = 0.4). Whereas, in cases of pilonidal abscess the recurrence rate was 27.9%. The difference was significant (p = 0.00001). Over all patients' satisfaction was very good/excellent in 187 (83.4%).

Conclusions

To reduce congestion of the operating lists in central hospitals, one can use a clear criterion based on the extent of the disease and the number of sinus openings, this will facilitate the management of pilonidal sinus disease in peripheral hospital settings, and comparable results can be achieved in terms of recurrence rate and patient satisfaction.

Abbreviations

Hidradenitis suppurativa

MGH

Almikhwah General Hospital

PSD

Pilonidal sinus disease

SSI

Surgical site infection

Pilonidal sinus

Pilonidal abscess

Acknowledgments

We are over helmed in all humbleness and gratefulness to acknowledge our depth to all those who have helped us to put these ideas, well above the level of simplicity and into something concrete. Special thanks to the employee in medical record department without their help this work couldn't see the light.

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.

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