Pilonadal disease: Rationale for the original method of radical surgery

Introduction. Considering the dissatisfaction with the results of existing methods for treating the pilonadal disease, the search for the most effective methods of radical surgery is currently ongoing. Aim. To evaluate the feasibility of using in patients with chronic epithelial coccygeal tract an original method of radical treatment, consisting of excision of the substrate of the disease, plastic surgery of the sacrococcygeal fascia and suturing of the soft tissue defect with vertical polyspaste sutures. Materials and methods. Main group: 34 patients who underwent an original method of radical surgical treatment. Comparison group: 34 patients who underwent traditional radical excision of the disease substrate. Results. In the main group, less severe pain was recorded ( p < 0.05) on days 1–6 after surgery. In terms of the total number of complications, a significant difference in results was demonstrated with a predominance of the indicator in patients in the comparison group (χ 2 = 12.324; p = 0.0004). A significant difference ( p < 0.05) was also obtained in the healing time of surgical wounds, with the lowest values in patients after the original surgical technique. Discussion. The study demonstrated an alternative technique, the implementation of which resulted in a significant reduction in the number of wound complications, severity of pain in the intervention area, average wound healing time, and also noted better quality of life indicators compared to patients who underwent traditional surgery. Conclusions. The implementation of an original method of radical surgical treatment of the epithelial coccygeal tract can reliably reduce the severity of pain on days 1–6 of the postoperative period, reduce the number of early postoperative complications by 38.23%, and also reduce the average wound healing time by 16 days compared with similar indicators after traditional radical excision of the pilonidal sinus.