Effect of surgical wound care methods of the lay open technique on the outcome of chronic sacrococcygeal pilonidal sinus management

Abstract

Background and objectives

The lay open technique is well established as an efficient treatment for chronic sacrococcygeal pilonidal sinus, but the postoperative care of the laid open wound is not well studied. In our study, we aim to evaluate four wound care methods that we used in our protocol to treat chronic sacrococcygeal pilonidal sinus by the lay open technique.

Materials and methods

A retrospective cohort study of 800 patients with chronic sacrococcygeal pilonidal sinus who accepted the lay open procedure was done. Postoperative care consisted of four methods: sitz bath three times daily at home (using warm water and 20 g salt for 10 minutes), normal saline cleaning three times daily at home, povidone iodine cleaning three times daily at home, and 3% hydrogen peroxide cleaning three times daily at home.

Results

No major side effects related to the material used in the wound care requiring surgical, medical intervention, or necessitating change of method were reported by any patient. The recurrence rate was zero (0%) in the hydrogen peroxide and the povidone iodine group after five years follow-up, while it was (1%) in the sitz bath group, and (2.5%) in the normal saline group.

Conclusion

The lay open technique could successfully achieve a zero (0%) recurrence rate with a very low rate of postoperative complications. Special consideration should be attributed to the wound care methods and materials used because they play a major role in the outcome. Hydrogen peroxide showed a superior wound care efficacy.