Day Care Surgery for Pilonidal Sinus Using Sinotomy Technique and Fibrin Glue Injection

Abstract

Selim Sozen, Vedat Ozturk, Koray Das, Hasan Erdem, Suleyman Cetinkunar, Ilhan Bali

Background: Pilonidal disease is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Different surgical methods have been described for the treatment. However, none of the methods has emerged as being superior to the others. An ideal treatment should be simple, lead to minimal disability, and have a rapid return to normal activity. We present the preliminary finding, an operative technique using fibrin glue in day-care surgery patients with a pilonidal sinus. Methods: 40 consecutive patients with a primary pilonidal sinus seen between September 2008 and February 2009 were prospectively submitted to sinotomy and fibrin glue injection under local anesthesia as day surgery cases. There were 35 males and 5 females (M:F 7:1) with a mean age of 26.8 years (range 17–50 years). Results: The mean duration of symptoms was 16.4 months (range 4–36 months). Mean operative time, including local anesthesia infiltration, was 17.3 min (range 15– 25 min). Postoperatively, the patient was observed for 15 minutes, then was discharged on oral analgesics containing paracetamol and codeine. All patients reported little or no discomfort after the procedure and were able to return to normal activities on the following day. There were no complications reported after surgery. Conclusion: An ideal surgical procedure for a pilonidal sinus should be one aiming at reducing hospital stay, minimizing tissue assault, promoting early work resumption, and preventing recurrence. The method described in this paper was found to be simple, safe, and feasible as day-care surgery. The technique of sinotomy with a good wound and surrounding skin care is an ideal approach with a high chance of cure. The patients returned to their routine within a short duration of time.