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Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial

Mahmoud F. Sakr, Mohammad A. Ramadan, Hossam M. Hamed, Hisham E. Kantoush.

Cited by (2)

Abstract
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&D) and healing by secondary intention (Group 1, n=66) or I&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&D and DE/DC of an acute pilonidal abscess, this is accompanied by a significantly higher overall complication rate than with I&D and secondary healing. Recurrence of an acute abscess or development of a chronic pilonidal sinus is similar with both procedures.

Key words: Pilonidal abscess, drainage, delayed excision, direct closure, recurrence


 
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This Article Cited By the following articles

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Pilonidal Disease: Review of Recent Literature
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How to Cite this Article
Pubmed Style

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. Arch Clin Exp Surg. 2012; 1(1): 8-13. doi:10.5455/aces.20120220101859


Web Style

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. http://www.ejmaces.com/?mno=15360 [Access: November 14, 2018]. doi:10.5455/aces.20120220101859


AMA (American Medical Association) Style

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. Arch Clin Exp Surg. 2012; 1(1): 8-13. doi:10.5455/aces.20120220101859



Vancouver/ICMJE Style

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. Arch Clin Exp Surg. (2012), [cited November 14, 2018]; 1(1): 8-13. doi:10.5455/aces.20120220101859



Harvard Style

Mahmoud F. Sakr, Mohammad A. Ramadan, Hossam M. Hamed, Hisham E. Kantoush (2012) Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial. Arch Clin Exp Surg, 1 (1), 8-13. doi:10.5455/aces.20120220101859



Turabian Style

Mahmoud F. Sakr, Mohammad A. Ramadan, Hossam M. Hamed, Hisham E. Kantoush. 2012. 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 (ACES), 1 (1), 8-13. doi:10.5455/aces.20120220101859



Chicago Style

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 (ACES) 1 (2012), 8-13. doi:10.5455/aces.20120220101859



MLA (The Modern Language Association) Style

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 (ACES) 1.1 (2012), 8-13. Print. doi:10.5455/aces.20120220101859



APA (American Psychological Association) Style

Mahmoud F. Sakr, Mohammad A. Ramadan, Hossam M. Hamed, Hisham E. Kantoush (2012) 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 (ACES), 1 (1), 8-13. doi:10.5455/aces.20120220101859





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