Operative Treatment Of Acute Sacrococcygeal Pilonidal Sinus With A Single Opening Under The Effect Of Local Anesthesia

Saadoon Atiyah, Taqi

	Operative Treatment Of Acute Sacrococcygeal Pilonidal Sinus With A Single Opening Under The Effect Of Local Anesthesia
Mustansiriya Medical Journal
Article 1, Volume 16, Issue 2, 2017, Pages 68-73
Author
Taqi Saadoon Atiyah
Abstract
Background: Pilonidal sinus is an acquired disease due to the collection of fallen hair in the sacrococcygeal area; there may be one or more openings which communicate with one or more tracts lined by granulation tissue. There are many surgical operations to treat the condition, but no single operation carries a 100% cure rate without the risk of recurrence. Financial considerations are important in the management of patients with pilonidal sinus, because it affects young adult patients, so admission to the hospital and the work off time has significant considerations in choosing the type of operative management. Objective: To study the significance of operative treatment of acute uncomplicated sacrococcygeal sinus under the effect of local anesthesia. Patients and Methods: A randomized cross sectional analytic study performed at the Al-Imamain Al-Kadhimain Medical City, for patients with acute pilonidal sinus with a single opening, over the period from April 2007 to April 2015. The operation was done in the theater with the patient in the prone position, local anesthetic infiltration around the opening of the sinus, and along its tract; incision along the tract of the sinus and laying it open, removing the hair, debris, and the granulation tissue by gently curating it. Excision of the lateral wall of the sinus, and the skin edges are trimmed, secure hemostasis, and dress the wound. Follow up of patients was daily for one week, then every week till complete healing occurred (usually 2-4 weeks), looking for any complications; then follow up of the patients every month for three months, and every three months for one and a half year, for any recurrence. Results: A total of 53 patients; 52 males (98.11%), and one female (1.88%), their age ranged from 17-39 years, mean age was 25.16±76 years. The patients presented with pain 43 (81.13%), infection was 8 (15.09%), and abscess 2 (3.77%) patients. The average healing time was about 2-4 weeks. The patients returned to their work one week after the operation. There were no complications other than one patient 1 (1.88%) who had recurrence after 9 months, and the procedure was repeated to him successfully. Conclusion: Treatment of sacrococcygeal pilonidal sinus under the effect of local anesthesia is a safe and simple procedure; there is no need for admission to the hospital, the patient can return to his work after one postoperative week, and the procedure can be repeated in case of recurrence.
Keywords
Acute Sacrococcygeal pilonidal sinus; Local anesthesia

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