A comparative study between the closed tie-over and open vacuum suction drainage procedures in patients with sacrococcygeal pilonidal sinus disease

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Abstract

Background
Multiple surgical techniques have been adopted for the management of patients with pilonidal disease. A great debate still exists among surgeons regarding the best option. We describe our experience in comparing the tie-over and open excision with vacuum suction drainage for the management of such a disease.
Patients and methods
This retrospective study reviewed the data of 65 patients diagnosed with pilonidal disease, who were allocated into two groups according to the performed procedure. The first group included 35 patients who underwent the tie-over approach, and the second one included 30 patients who underwent open vacuum drainage.
Results
The demographic and preoperative clinical patient criteria were statistically comparable between the two groups. The tie-over approach showed a significant prolongation of the operative time (75.29 vs. 50.57 min in the vacuum group). Hospital stays and pain scores showed no significant difference between the study groups. Time to painless walking had median values of 6 and 8 days, whereas the same values were 7 and 9 days for painless toilet seat in the tie-over approach and the vacuum group, respectively. Return to daily activities occurred after 3 and 4 weeks, whereas complete wound healing was noticed in 2 and 5 weeks in the tie-over approach and the vacuum group, respectively. Recurrence was noted in 5.71 and 3.33% of patients in the tie-over approach and the vacuum group, respectively.
Conclusion
The tie-over approach was associated with better postoperative outcomes, including faster wound healing and better recovery profile, with comparable recurrence rates, compared with the open vacuum suction approach.

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