Technical Comparison of Three Surgical Methods: Open, Semi-closure, and Primary Closure in the Treatment of Pilonidal Sinus

Pilonidal sinus of the sacrum is a relatively common chronic infectious disease. Surgical management of pilonidal sinus is a challenging matter, and despite the different surgical techniques, the recurrence rate is still high.

This double-blind clinical trial study was conducted on 60 patients with pilonidal sinus (2023). These patients underwent surgery randomly and based on the available sampling method in three

open, semi-closure, and primary closure. Recovery time and intraoperative bleeding were recorded. The McGill Pain Questionnaire was used to evaluate postoperative pain, and the Southampton scale was employed to assess infection and secretions.

The recovery time was longer in the open method than in the closure and semi-closure methods (P=0.001). However, this difference did not exist between the closure and semi-closure methods (P=0.402). There were two cases of recurrence in the closed method, while no recurrence was observed in the open and semi-closure methods. The patients undergoing the closure surgical method experienced less bleeding postoperatively (P=0.002). No significant relationship was found between surgical method and infection (P=0.189). There was no significant difference in the intensity of pain experienced by patients after the operation (P=0.789).

For the treatment of pilonidal sinus, primary surgical closure is not recommended due to recurrences, despite the shorter recovery time and less bleeding. The semi-closure surgical method seems to be safer than the open and primary closure methods.