PILONODAL SINUS

MANAGEMENT OF PILONODAL SINUS WITH Z PLASTY TECHNIQUE: A STUDY OF 7 YEARS.

Abstract

Objectives: Pilonidal sinus is chronic inflammatory condition that usually affect
young adult population, despite the current medical advances in the field of medical sciences.
The acceptable management of pilonidal sinus is still lacking. This study evaluates the outcome
of pilonidal sinus after excision of the whole tract then its closure with a Z plasty technique which
is a simple cleft lip repair like method which provides a quick and comfortable remedy. Design:
A seven years retrospective study. Setting: Surgical Department of Peoples Medical College
Hospital (later University) and at Private Medical Center at Nawabshah. Period: January 2010
to March 2017. Methodology: A total of 55 patients suffering from pilonidal sinus were admitted
at both sites from the outdoor department. All the data were collected from the admitted record
and proforma. All required investigations were done. Excision of sinus followed by Z plasty
closure were done in a single stage with drain put by separate stab on one side of the wound.
Results: Out of total 55 patients 41 (74.5%) patients recovered smoothly while 6 (10%) patients
developed major wound disruption, 3 (5.45%) patients developed minor wound disruption and
5 (9.09%) developed wound dehiscence. Conclusion: Primary closure of pilonidal sinus with Z
plasty technique is technically a simple closure method which provides a comfortable closure
with minimum results of wound disruption and dehiscence. Healing is rapid due to comfortable
approximation of the wound flaps and thus avoids the problem created in simple closure
technique. It can be applicable with every type of patients from heavy build to thin build type.