Sacrococcygeal pilonidal sinus (PNS) is a common disease. There are different lines of
treatment but the best surgical technique is still controversial. The aim of this study is to show
the effectiveness of treatment of sacrococcygeal PNS with excision and primary midline closure
as day case surgery. This is the first study on sacrococcygeal PNS to be done in Sulaymania
governorate, Iraq.
A prospective study was done over a period of 3 years, between 1st Jan 2003 and 31st Dec
2005 in a private general surgical office, in Sulaymania city, Iraq, where 78 cases of chronic
symptomatic, uncomplicated, nonrecurrent sacrococcygeal PNS were seen. From these 78
patients 6 patients refused operation and they were excluded from the study. Data collected
from the remaining 72 patients were age, gender, presenting complaint and its duration,
operative findings, duration of the operation, time of wound healing, any hospitalization if
required, time to return to work, postoperative complications, postoperative pain, wound
hematoma, wound infection, wound disruption, recurrence of the sinus, cost of the operation,
patient satisfaction about the treatment and follow up compliance of the patients. They were
treated with excision and primary midline closure technique. From the total no of 72 patients, 7
patients were unable to complete the follow up period and they were excluded from the study,
and we continued the study of the outcome data of the remaining 65 patients.
Of those 65 patients treated excision and primary midline closure, 1 patient (1.53%) developed
wound disruption, 4 patients (6.14%) developed surgical site infection (SSI) and only 3 patients
(4.61%) had reccurence of the sinus.
It is concluded that excision and primary midline closure technique is simple, convenient,
economic and successful treatment as day case surgery for chronic, sympotomatic,
uncomplicated and non recurrent sacrococcygeal PNS.K