Excision and primary closure of pilonidal sinus: excellent results

Arun Singh, Sujit Kumar, Vidur Jyoti, Preeti Yadav, Akhilesh Pandey


Background: Pilonidal sinus (PNS) is an acquired condition described as a chronic sinus containing hairs and found between the buttocks. Best surgical method is still being searched for treatment of PNS in terms of minimizing disease recurrence and patient discomfort.

Methods: The prospective study of 40 patient undergoing excision and primary closure of pilonidal sinus from October 2013 to July 2016 at Max Super Speciality Hospital Gurgaon.

Results: Mean operative time was 30 minutes. One patient developed hematoma due to blockage of drain on post-operative day 2 which was flushed with saline and drain made patent, one patient developed seroma and one had wound infection. Rest other patients had uneventful course post operatively. No recurrence was noted over 6 month follow up.

Conclusions: We advocate this method of treating PNS which is simple, less time consuming, short hospital stay, rapid healing, shorter time off work, minimal recurrence with excellent results.


Drain, Excision, Pilonidal sinus, Primary closure

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Aldean I, Shankar PJ, Mathew J, Safarani N, Haboubi NY. Simple excision and primary closure of pilonidal sinus: a simple modification of conventional technique with excellent results. Colorectal Dis. 2005;7:81-5.

Yoldas T, Karaca C, Unalp O. Recurrent pilonidal sinus: lay open or flap closure, does it differ? Int Surg. 2013;98:319-23.

Kosaka M, Kida M, Mori H, Kamiishi H. Pilonidal cyst of the scalp due to single minor trauma. Dermatologic Surg. 2007;33(4):505-7.

Perruchoud C, Vuilleumier H, Gvel JC. pilonidal sinus: How to choose between excision and open granulation versus excision and primary closure? Swiss Surg. 2002;8(6):255-8.

Abdelnour A, Aftinos G, Elmasri H. Conservative surgical treatment of 27 cases of umbilical pilonidal sinus. J Med Lebanon. 1994;42:123-5.

Patel MR, Bassini L, Nashad R, Anselmo MT. Barber’s inter-digital pilonidal sinus of the hand: a foreign body hair granuloma. J Hand Surg Am. 1990;15:652-5.

Ohtsuka H, Arashiro K, Watanabe T. Pilonidal sinus of the axilla: report of five patients and review of literature. Ann Plast Surg. 1994;33:322-4.

Miyata T, Toh H, Doi F, Torisu M. Pilonidal sinus of the neck. Surg Today. 1992;22:379-82.

Ferdinand RD, Scott DJ, McLean NR. Pilonidal cyst of the breast. Br J Surg. 1997;84:784.

Cima RR. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery; Philadelphia, PA: Saunders Elsevier. 18th ed, Volume 2. 2008:1449-1450.

Lunnis PJ. The Anus and anal canal. In: Williams NS, Bulstrode CJS. O’Connel PR, eds. Bailey and Love’s Short Practice of Surgery, 25th ed. London Arnold: 2008:1247-1249.

Khalid K. Outcome of surgery for chronic natal cleft pilonidal sinus: A randomized trial of open compared with closed technique. JCPSP. 2001;11:32-5.

Sondenaa K, Nesvik I, Abderson E, Natas O, Soreide JA. Characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995;10(1):39-42.

Armstrong JH, Barcia PJ, Pilonidal sinus disease. The conservative approach. Arch Surg. 1994;129:914-7.

Tekin A. Pilonidal sinus: experience with Limberg flap. Colorectal Dis. 1999;1:29-33.

Milito G, Gortese F, Casciani CU. Rhomboid flap procedure for pilonidal sinus: results from 67 cases. Int J Colorectal Dis. 1998;13:113-5.

Chintapatla S, Safarani N, Kumar S, Haboubi N. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options, Techniques Coloproctol. 2003;7(1):3-8.

can mf, sevinc mm, yilmaz m. comparison of karydakis flap reconstruction versus midline closure in sacrococcygeal pilonidal disease: results of 200 military service members. Surgery Today.2009;39(7):580-6.

Chiedozi LC, Al-Rayyes FA, Salem MM, Al-Haddi FH, Al-Bidewi AA. Management of pilonidal sinus. Saudi Med J. 2002;23:786-8.

Da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum. 2000;43:1146-56.

Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980;87:56-2.

Tritapepe R, Padova DC. Excision and primary closure of pilonidal sinus using a drain for antiseptic wound flushing. Am J Surg. 2002;183:209-11.

Williams RS. A simple technique for successful primary closure after excision of pilonidal sinus disease. Ann R Coll Surg Engl. 1990;72(5):313-5.

Azab AS, Kamal MS, El Bassyoni F. The rationale of using the rhomboid fasciocutaneous transposition flap for the radical cure of pilonidal sinus. J Dermatol Surg Oncol. 1986;12:1295-9.

Katsoulis IE, Hibberts F, Carapeti EA. Outcome of treatment of primary and recurrent pilonidal sinuses with the Limberg flap. Surgeon. 2006;4(1):7-10.

Werkgartner G. Knowledg-based therapy of the pilonidal sinus. Eur Surg. 2004;36(3):170-1.

Ertam T, Koc M, Gocmen E, Aslar K, Keskek M, Kilic M. Does technique alter quality of life after pilonidal sinus surgery? Am J Surg. 2005;190:388-92.