Usage of Subcutaneous Guide-Wide and Intra-Lesional Dyes for Radical Excision of Pilonidal Sinus: A Reliable and Adequate Method for Excision and Wound Closure

Background: Total excision of pilonidal sinus and wound reconstruction is challenging and no ideal therapy has jet been found(1). How to adequately excise the whole tract of pilonidal sinus without removing excessive healthy tissue is important. Various surgical methods have been described for pilonidal sinus, such as phenol application(2), open method, repaired with local flap(3-5), and repaired with fasciocutaneus flap(6). But no single method can solve the problem. We had used a consistent surgical technique to excise the whole tract of pilonidal sinus and closed the wound under tension free in our hospital.

Patients and Methods: We has collected 10 patients who has undergone pilonidal sinus excision and wound reconstruction from March 2013 to November 2017. We used the Nelaton tube for identification of subcutaneous tract and injected the blue dye into the whole tract. When excision was arranged, we could not only excise the whole tract without damage to the sinus wall but also have guideline to avoid removing excessive healthy tissue. After excision, bilateral advance flap was used for wound closured under tension free.

Results: The average follow up time was 24.6 months. No sinus recurrence was found during our follow up. Post-operative care included local wound care, antibiotics treatment, and absolute prone position were applied for 2 weeks. No remarkable post-operative complications were found. All the patients achieved satisfactory results. 

Conclusion: The subcutaneous guide-wide and intra-lesional dyes for radical excision of pilonidal sinus and wound reconstruction can reduce the recurrent rate without notable morbidity.

Reference:

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