A comparison of two operations for pilonidal sinus disease

Background: Postoperative wound complications have always been the main cause of concern followed by the risk of recurrence, in the surgical treatment of the pilonidal sinus disease. Various techniques evolved so far mainly aimed at solving these problems. This clinical study compares the results obtained through random allocation of patients between those subjected to, a) using the excision and marsupialisation technique and b) the technique of excision of the sinus tracts using a radiofrequency device.
Methods: A total of 28 patients of chronic pilonidal sinus disease were randomised to undergo radiofrequency sinus excision technique (n=14) or excision and marsupialisation (n=14). The demographic data. Postoperative results complications and recurrence were documented for comparison of the results. Patients from both the groups were recalled after 12 months to assess recurrence.
Results: Radiofrequency technique resulted to reducing the execution time (13 versus 34 minutes) as well as the hospital stay (9 versus 30 hrs). The postoperative pain (p=0.0044) and period off work (p=0.0019) was more with the marsupialisation technique. Two patients from marsupialisation developed wound infection. At subsequent follow-up, there was one case of recurrence in each group.
Conclusion: in dealing with a limited, chronic pilonidal disease, the radiofrequency sinus excision technique has definite advantages over sinus excision and marsupialisation technique. It needed a shorter hospital stay with reduction on postoperative pain and early resumption to work.

Keywords
Pilonidal sinus, excision and marsupialisation, radiofrequency surgery, recurrence