Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial
Objective: To compare drainage and healing by secondary intention with drainage, delayed excision and direct closure (DE/DC). Methods: Between January 2003 and January 2010, 130 patients admitted with an acute pilonidal abscess were randomized to undergo either elliptical incision and drainage (I an...
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| Format: | Article |
| Language: | English |
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GESDAV
2012-02-01
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| Series: | Archives of Clinical and Experimental Surgery |
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| Online Access: | http://www.scopemed.org/fulltextpdf.php?mno=15360 |
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| author | Mahmoud F. Sakr Mohammad A. Ramadan Hossam M. Hamed Hisham E. Kantoush |
| author_facet | Mahmoud F. Sakr Mohammad A. Ramadan Hossam M. Hamed Hisham E. Kantoush |
| author_sort | Mahmoud F. Sakr |
| collection | DOAJ |
| description | Objective: To compare drainage and healing by secondary intention with drainage, delayed excision and direct closure (DE/DC).
Methods: Between January 2003 and January 2010, 130 patients admitted with an acute pilonidal abscess were randomized to undergo either elliptical incision and drainage (I and D) and healing by secondary intention (Group 1, n=66) or I and D and DE/DC (Group 2, n=64). Data regarding patient and sinus characteristics, hospital stay, healing time, postoperative complications, and recurrence were prospectively collected. Patients were followed-up for a mean of 62.4 months.
Results: Ninety percent of patients were men and 10% were women, with a mean age of 26.4 years and a mean body mass index of 31.5. There was no difference in hospital stay between both groups. Mean healing time was significantly (p=0.035) longer for patients in group 1 (32.2 days), compared to those in group 2 (10.7 days). Group 1 patients had significantly fewer postoperative complications (4.5% versus 17.2%, respectively) (p=0.020). The 2 groups had a similar recurrence rate of a pilonidal abscess (6.1% versus 6.3%, p=0.984), and a rate of development of a chronic pilonidal sinus (PNS) (25.8% versus 23.4%, p=0.840).
Conclusions: Although there is more rapid healing and fewer visits for dressing with I and D and DE/DC of an acute pilonidal abscess, this is accompanied by a significantly higher overall complication rate than with I and D and secondary healing. Recurrence of an acute abscess or development of a chronic pilonidal sinus is similar with both procedures. [Arch Clin Exp Surg 2012; 1(1.000): 8-13] |
| first_indexed | 2024-04-10T12:08:51Z |
| format | Article |
| id | doaj.art-259b4ed8ff694ca1a85355a7c997cb61 |
| institution | Directory Open Access Journal |
| issn | 2146-8133 |
| language | English |
| last_indexed | 2024-04-10T12:08:51Z |
| publishDate | 2012-02-01 |
| publisher | GESDAV |
| record_format | Article |
| series | Archives of Clinical and Experimental Surgery |
| spelling | doaj.art-259b4ed8ff694ca1a85355a7c997cb612023-02-15T16:16:05ZengGESDAVArchives of Clinical and Experimental Surgery2146-81332012-02-011181310.5455/aces.2012022010185915360Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized TrialMahmoud F. Sakr0Mohammad A. Ramadan1Hossam M. Hamed2Hisham E. Kantoush3Department of Surgery, Faculty of Medicine, University of Alexandria, Egypt Department of Surgery, Medical Research Institute, University of Alexandria, Egypt Department of Surgery, Ahmadi Hospital, KOC, Kuwait Department of Surgery, Ahmadi Hospital, KOC, KuwaitObjective: To compare drainage and healing by secondary intention with drainage, delayed excision and direct closure (DE/DC). Methods: Between January 2003 and January 2010, 130 patients admitted with an acute pilonidal abscess were randomized to undergo either elliptical incision and drainage (I and D) and healing by secondary intention (Group 1, n=66) or I and D and DE/DC (Group 2, n=64). Data regarding patient and sinus characteristics, hospital stay, healing time, postoperative complications, and recurrence were prospectively collected. Patients were followed-up for a mean of 62.4 months. Results: Ninety percent of patients were men and 10% were women, with a mean age of 26.4 years and a mean body mass index of 31.5. There was no difference in hospital stay between both groups. Mean healing time was significantly (p=0.035) longer for patients in group 1 (32.2 days), compared to those in group 2 (10.7 days). Group 1 patients had significantly fewer postoperative complications (4.5% versus 17.2%, respectively) (p=0.020). The 2 groups had a similar recurrence rate of a pilonidal abscess (6.1% versus 6.3%, p=0.984), and a rate of development of a chronic pilonidal sinus (PNS) (25.8% versus 23.4%, p=0.840). Conclusions: Although there is more rapid healing and fewer visits for dressing with I and D and DE/DC of an acute pilonidal abscess, this is accompanied by a significantly higher overall complication rate than with I and D and secondary healing. Recurrence of an acute abscess or development of a chronic pilonidal sinus is similar with both procedures. [Arch Clin Exp Surg 2012; 1(1.000): 8-13]http://www.scopemed.org/fulltextpdf.php?mno=15360Pilonidal abscessdrainagedelayed excisiondirect closurerecurrence |
| spellingShingle | Mahmoud F. Sakr Mohammad A. Ramadan Hossam M. Hamed Hisham E. Kantoush Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial Archives of Clinical and Experimental Surgery Pilonidal abscess drainage delayed excision direct closure recurrence |
| title | Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial |
| title_full | Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial |
| title_fullStr | Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial |
| title_full_unstemmed | Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial |
| title_short | Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial |
| title_sort | secondary healing versus delayed excision and direct closure after incision and drainage of acute pilonidal abscess a controlled randomized trial |
| topic | Pilonidal abscess drainage delayed excision direct closure recurrence |
| url | http://www.scopemed.org/fulltextpdf.php?mno=15360 |
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