The outcome of pilonidal sinus abscess drainage: a comparative study

Abstract

Backgrounds  and  aim:  A  pilonidal  sinus  (PNS)  is  a  common condition  that  affects  men  mostly  especially  young  adults.  The method of treatment of this surgical condition is controversial still. In  this  regard,  we  compared  the  outcomes  of  interest  between excision and drainage of an abscess in PNS patients.  
Methods:  Patients  who  were  diagnosed  with  PNS  abscess  and admitted  for  the  treatment  between  2019  and  2020  were  treated either by excision (n=48) or drainage of abscess (n=30). The patients were  followed  up  for  the  outcomes  of  the  interest,  including infection, pain, discharge, and wound size at the first, third, and sixth months of surgery.  
Results: The patients who were treated by excision technique had significantly longer operative time compared to patients who were treated  by  drainage  of  abscess  9.65  vs.  5.50  min,  P<0.0001.  In addition, they had a longer postoperative hospitalization time, 4.19 vs. 3.43 hours, P=0.0002, and required longer time to back to normal activity, 4.69 vs. 4.20 days, P=0.0221, respectively. The patients in both  groups  had  similar  incidence  rates  of  infection,  pain,  and discharge  at  the  different  periods  and  similar  incidence  rates  of wound rate at the first month. The patients who were treated by drainage of abscess had significantly higher incidence rates of two and three cm wound size compared to those who were treated by excision. 75.00%, P=0.4287, whereas, the patients who were treated by drainage of abscess significantly developed postoperative fever, 16.67% vs. 0.00%, P=0.018.  
Conclusions: The study showed that total excision of pilonidal sinus abscess develop better outcomes of the wound at third and sixth months of operation.