Comparison of Monopolar and Bipolar Electrocautery Excision Techniques in Pilonidal Sinus Disease: A Retrospective Clinical Study

There is no standard method for the treatment of pilonidal sinus disease (PSD). Today, many different treatment methods are attempted. Some of the leading methods are surgical procedures with different flap techniques and less invasive methods, such as crystallized phenol, laser pilonidoplasty, radiofrequency excision, and monopolar electrocautery excision.

This study aimed to compare the monopolar and bipolar electrocautery excision techniques that we performed in our clinic for PSD.

Patients who received pilonidal sinus treatment in our clinic between January 2018 and January 2021 were analyzed retrospectively. The exclusion criteria were diabetes mellitus, renal failure, immunosuppression, and children (<16 years of age). The study included a total of 36 patients who met the criteria. Data were retrospectively obtained from hospital archive records (operative notes, discharge summary, and outpatient dressing records). The patients were then divided into two groups, namely monopolar electrocautery excision (group 1) and bipolar electrocautery excision (group 2).

The mean age of 36 patients included in the study was 22.9 years. There was no difference between the two groups in terms of predisposing factors (gender, obesity, hirsutism, and smoking). There was also no statistical difference in terms of mean healing time and recurrence rate. Monopolar and bipolar electrocautery excisions lasted 32.2±8.9 and 38.8±7.8 minutes, respectively (P<0.05). Accordingly, the operative time was significantly different between the groups, and it was shorter in the monopolar electrocautery excision group. Furthermore, the bipolar electrocautery group showed shorter wound infection duration, compared to the monopolar electrocautery excision group (P<0.05).

Both excision techniques were similar in terms of wound healing, hospital stay, and recurrence rates. The operative times were longer in bipolar cautery; however, the wound infection was less.