Introduction
Pilonidal sinus is a benigne disease localised almost exclusively at the sacrococcigeo level, constituited by a cist and/or fistulous track containing hairs in 50% of cases. Fistula always represent the result of the abscessual complicance of pilonidalis cist usually unknow until infection.Various treatments have been proposed, but the ideal treatment should consent a rapid recovery with minimal discomfort of the patient , low relapse rate and early return to normal activity.
Methods
25 patients effected with pilonidal fistula localised at the sacrococcigeo level underwent surgical treatment, with local anasthesia.The patients were randomly subdivided into 2 groups. The first group was made of 12 units and managed with Lord-Millar treatment. This method consist, after infiltration of anasthetic solution, probing and injectioning methilene blue, to perform a single excission leaving only tiny wound. The track is then stretched with forceps and brushed with nylon bristies to remove the hairs and debris.The second group, composed of 13 patients , was treated with primary closure and sucking drainage. Under evaluation were, the average time in hospital, the number of recurrences, time before return to normal activity and the healing time. In the patients from the first group, during the medications there was frequent curettage. The followup varied from a minimum of 36 months to a maximum of 72 months; the data was evaluated through the adaptation of the Student t.
Results
No significant difference was observed between the ages and the sexes. All the patients of the first group were discarged about two hours after surgical treatment; in the patients of the second group the average time in hospital was about 2 ยฑ 5 days (P<0.05). The time for return to normal activity was 10 ยฑ 20 days in the first group and 12 ยฑ 15 in the second group(p>0.05). The ealing time was 20 ยฑ 15 days in the first group and 15 ยฑ 10 in the second group (P<0.05). Two recurrence were observed: one in the first group and one in the second. CONCLUSIONS Even if ealing time resulted much longer then excission with primary closure, we prefer the Lord Millar method because its easy to perform and always ambulatorial regime.