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Treatment of Pilonidal Sinus by Primary Closure: A Seven-Year Study

Treatment of Pilonidal Sinus by Primary Closure: A Seven-Year Study Abstract The surgical treatment of pilonidal sinus has remained controversial. Reports from various institutions have shown a wide variation in the incidence of wound-healing complications, and follow-up studies have similary shown a wide variation in the recurrence rate. Several years ago a technique of excision and primary closure was described, and preliminary follow-up studies were reported.14 Our purpose now is to bring this study up to date and present the results of long-term follow-up study. The operation which we have used throughout this seven-year study is a modification of the bilateral musculofascial-flap procedure described by Holman5 in 1946. Our technique differs from the one described by Holman in that we have used no buried suture material, wound closure has been obtained by means of removable farand-near sutures2,15 of stainless steel inserted through fascia and subcutaneous tissue, as well as skin, and the wounds have been closed without drainage. References 1. Abramson, D. J., and Cox, P. A.: The Marsupialization Operation for Pilonidal Cysts and Sinuses Under Local Anesthesia with Lidocaine: Ambulatory Method of Treatment , Ann. Surg. 139:341, 1954.Crossref 2. Babcock, W. W.: A Text-Book of Surgery for Students and Physicians , Philadelphia, W. B. Saunders Company, 1928, p. 604. 3. Close, A. S.: Pilonidal Cysts: An Analysis of Surgical Failures , Ann. Surg. 141:523, 1955.Crossref 4. Dwight, R. W.: Pilonidal Sinus: An Evaluation of Plastic Closure Using Flaps of Gluteal Muscle , A. M. A. Arch. Surg. 64:438, 1952.Crossref 5. Holman, E.: Pilonidal Sinus—Treatment by Primary Closure , Surg. Gynec. & Obst. 83:94, 1946. 6. Hopping, R. A.: Pilonidal Disease: Review of the Literature with Comments on the Etiology, Differential Diagnosis, and Treatment of the Disease , Am. J. Surg. 88:780, 1954. 7. Lawrence, K. B., and Baker, W. J.: The Marsupialization Operation for Pilonidal Sinus: Comparison with Other Surgical Methods in 359 Cases , New England J. Med. 245:134, 1951. 8. Miscall, L., and Holder, J. S.: Pilonidal Sinus: Method of Closure by Musculo-Fascial Flaps , Mil. Surgeon 93:457, 1943. 9. Pecora, 1). V., and Cooper, P.: Pilonidal Sinus: Analysis of 206 Operations Performed According to Varying Techniques , A. M. A. Arch. Surg. 71:752, 1955. 10. Pope, C. E.: New and Successful Closed Operative Procedure for Pilonidal Sinus: Gluteus Maximus Mobilization; a Sliding Muscle Graft Procedure , Arch. Surg. 52:701, 1946. 11. Pope, C. E., and Hudson, II. W.: Pilonidal Sinus: A Review of 130 Consecutive Cases in Which Patients Were Treated by Closure; A New Closed Operative Method and Management , Arch. Surg. 52:690, 1946. 12. Shute, F. C., Jr.; Smith, T. E.; Levine, M., and Burch, J. C.: Pilonidal Cysts and Sinuses , Ann. Surg. 118:706, 1943. 13. Swinton, N. W., and Markee, R. K.: Present Status of the Treatment of Pilonidal Sinus Disease , Am. J. Surg. 86:562, 1953. 14. Turner, F. P.: Pilonidal Sinus: Primary Closure with Equal Musculofascial Flaps and Removable Far-and-Near Sutures; Analysis of 59 Consecutive Cases , Ann. Surg. 140:687, 1954. 15. Whipple, A. O., and Elliott, R. II E., Jr.: The Repair of Abdominal Incisions , Ann. Surg. 108:741, 1938. 16. Ziegler, II. R.; Murphey, D. R., Jr., and Meek, E. M.: Pilonidal Cyst and Sinus: New Method of Excision with Primary Closure , Surgery 20:690, 1946. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Treatment of Pilonidal Sinus by Primary Closure: A Seven-Year Study

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1959.04320030042008
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Abstract

Abstract The surgical treatment of pilonidal sinus has remained controversial. Reports from various institutions have shown a wide variation in the incidence of wound-healing complications, and follow-up studies have similary shown a wide variation in the recurrence rate. Several years ago a technique of excision and primary closure was described, and preliminary follow-up studies were reported.14 Our purpose now is to bring this study up to date and present the results of long-term follow-up study. The operation which we have used throughout this seven-year study is a modification of the bilateral musculofascial-flap procedure described by Holman5 in 1946. Our technique differs from the one described by Holman in that we have used no buried suture material, wound closure has been obtained by means of removable farand-near sutures2,15 of stainless steel inserted through fascia and subcutaneous tissue, as well as skin, and the wounds have been closed without drainage. References 1. Abramson, D. J., and Cox, P. A.: The Marsupialization Operation for Pilonidal Cysts and Sinuses Under Local Anesthesia with Lidocaine: Ambulatory Method of Treatment , Ann. Surg. 139:341, 1954.Crossref 2. Babcock, W. W.: A Text-Book of Surgery for Students and Physicians , Philadelphia, W. B. Saunders Company, 1928, p. 604. 3. Close, A. S.: Pilonidal Cysts: An Analysis of Surgical Failures , Ann. Surg. 141:523, 1955.Crossref 4. Dwight, R. W.: Pilonidal Sinus: An Evaluation of Plastic Closure Using Flaps of Gluteal Muscle , A. M. A. Arch. Surg. 64:438, 1952.Crossref 5. Holman, E.: Pilonidal Sinus—Treatment by Primary Closure , Surg. Gynec. & Obst. 83:94, 1946. 6. Hopping, R. A.: Pilonidal Disease: Review of the Literature with Comments on the Etiology, Differential Diagnosis, and Treatment of the Disease , Am. J. Surg. 88:780, 1954. 7. Lawrence, K. B., and Baker, W. J.: The Marsupialization Operation for Pilonidal Sinus: Comparison with Other Surgical Methods in 359 Cases , New England J. Med. 245:134, 1951. 8. Miscall, L., and Holder, J. S.: Pilonidal Sinus: Method of Closure by Musculo-Fascial Flaps , Mil. Surgeon 93:457, 1943. 9. Pecora, 1). V., and Cooper, P.: Pilonidal Sinus: Analysis of 206 Operations Performed According to Varying Techniques , A. M. A. Arch. Surg. 71:752, 1955. 10. Pope, C. E.: New and Successful Closed Operative Procedure for Pilonidal Sinus: Gluteus Maximus Mobilization; a Sliding Muscle Graft Procedure , Arch. Surg. 52:701, 1946. 11. Pope, C. E., and Hudson, II. W.: Pilonidal Sinus: A Review of 130 Consecutive Cases in Which Patients Were Treated by Closure; A New Closed Operative Method and Management , Arch. Surg. 52:690, 1946. 12. Shute, F. C., Jr.; Smith, T. E.; Levine, M., and Burch, J. C.: Pilonidal Cysts and Sinuses , Ann. Surg. 118:706, 1943. 13. Swinton, N. W., and Markee, R. K.: Present Status of the Treatment of Pilonidal Sinus Disease , Am. J. Surg. 86:562, 1953. 14. Turner, F. P.: Pilonidal Sinus: Primary Closure with Equal Musculofascial Flaps and Removable Far-and-Near Sutures; Analysis of 59 Consecutive Cases , Ann. Surg. 140:687, 1954. 15. Whipple, A. O., and Elliott, R. II E., Jr.: The Repair of Abdominal Incisions , Ann. Surg. 108:741, 1938. 16. Ziegler, II. R.; Murphey, D. R., Jr., and Meek, E. M.: Pilonidal Cyst and Sinus: New Method of Excision with Primary Closure , Surgery 20:690, 1946.

Journal

A.M.A. Archives Surgery – American Medical Association

Published: Mar 1, 1959

References

  • The Marsupialization Operation for Pilonidal Cysts and Sinuses Under Local Anesthesia with Lidocaine: Ambulatory Method of Treatment
    Abramson , D. J., and Cox, P. A.
  • A Text-Book of Surgery for Students and Physicians
    Babcock , W. W.
  • Pilonidal Cysts: An Analysis of Surgical Failures
    Close , A. S.
  • Pilonidal Sinus: An Evaluation of Plastic Closure Using Flaps of Gluteal Muscle
    Dwight , R. W.
  • Pilonidal Sinus—Treatment by Primary Closure
    Holman , E.
  • Pilonidal Disease: Review of the Literature with Comments on the Etiology, Differential Diagnosis, and Treatment of the Disease
    Hopping , R. A.
  • The Marsupialization Operation for Pilonidal Sinus: Comparison with Other Surgical Methods in 359 Cases
    Lawrence , K. B., and Baker, W. J.
  • Pilonidal Sinus: Method of Closure by Musculo-Fascial Flaps
    Miscall , L., and Holder, J. S.
  • Pilonidal Sinus: Analysis of 206 Operations Performed According to Varying Techniques
    Pecora , 1). V., and Cooper, P.
  • New and Successful Closed Operative Procedure for Pilonidal Sinus: Gluteus Maximus Mobilization
    Pope , C. E.
  • Pilonidal Sinus: A Review of 130 Consecutive Cases in Which Patients Were Treated by Closure
    Pope , C. E., and Hudson, II. W.
  • Pilonidal Cysts and Sinuses
    Shute , F. C., Jr.; Smith, T. E.; Levine, M., and Burch, J. C.
  • Present Status of the Treatment of Pilonidal Sinus Disease
    Swinton , N. W., and Markee, R. K.
  • Pilonidal Sinus: Primary Closure with Equal Musculofascial Flaps and Removable Far-and-Near Sutures
    Turner , F. P.
  • The Repair of Abdominal Incisions
    Whipple , A. O., and Elliott, R. II E., Jr.
  • Pilonidal Cyst and Sinus: New Method of Excision with Primary Closure
    Ziegler , II. R.; Murphey, D. R., Jr., and Meek, E. M.