A comparative Study between Open Excision  and Modified Bascom's Technique in Sacro- Coccygeal Pilonidal Sinus

Hillu Surriah, Mohammed

	A comparative Study between Open Excision and Modified Bascom's Technique in Sacro- Coccygeal Pilonidal Sinus
Iraqi Postgraduate Medical Journal
Article 1, Volume 14, Issue 1, 2015, Pages 53-61 PDF (0 K)
Author
Mohammed Hillu Surriah
Abstract
ABSTRACT: BACKGROUND: Pilonidal sinus is a common disabling disease of young adults involving the sacro- coccygeal area, in the natal cleft , consisting of one or more, usually non-infected, midline openings, which communicate with a fibrous track lined by granulation tissue and containing hair lying loosely within the lumen. Many of the standard surgical procedures are associated with a significant risk both of delayed healing and of recurrent disease. OBJECTIVE: The study aimed to comparing the results of excision and packing method with those of lateral approach (Modified Bascom's procedure) in the treatment of sacro - coccygeal pilonidal sinus in regard to the hospital stay, time required for complete healing , time required to return to daily job or activity, early complications (infection, wound hematoma or seroma ) and late complications (scar and recurrence) . METHODS : Eighty patients were operated on electively for pilonidal sinus, (62) male, (18) female who underwent elective operations of sacro-coccygeal pilonidal sinus at AL-Karama Teaching Hospital between June 2009 - June 2014 . Two surgical procedures were carried out, excision and packing (40 patients, group A) and modified Bascom's procedure (lateral approach) (40 patients, group B)" Five patients omitted from further follow 'up, two cases related to excision and packing and three of modified Bascom's procedure . RESULTS : It has been found that the third decade of life is the most frequent age group at which patient presenting symptoms was discharge (61.2%) and pain (26.2%) although both present in combination in most cases' 75% and 52%) of patients had discharge and pain respectively during the presenting period . The duration of the disease was from one month to two years. It has been concluded that there was no significant difference in the occurrence of the early complication ( infection , seroma / hematoma) 25% for group A and 37.5% group B, and recurrence rate l0.5 % for group A and 16.2% for group B , thus patients in group B provided a significantly quicker healing time { mean 49 days for group A and 28 days for group B }. Shorter time - work { mean 47.8 days for group A and 28 days for group B } with better patient convenience (more pain free period), needs only simple oral analgesia , no patient needed hospital admission for pain control no dressing required and less risk of wound break down . CONCLUSION : The study had shown that modified Bascom's procedure for pilonidal sinus is safe and feasible as day-care surgery and is associated with potential cost saving.
Keywords
KEYWORDS; modified bascom; sacro; coccygeal

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