COMPARISON PRIMARY CLOSURE AND OPEN TECHNIQUE IN THE TREATMENT OF PILONIDAL SINUS SURGERY IN MTI-LADY READING HOSPITAL PESHAWAR

Background: Pilonidal sinus disease is a common condition that requires surgical intervention, with primary closure and open techniques being the two main approaches. While both methods aim to manage the disease and promote healing, they differ regarding postoperative recovery, complication rates, and overall outcomes. In many cases, primary closure offers benefits in terms of reduced recovery time and fewer complications, but the comparison between these two techniques remains underexplored in specific settings. This study aims to compare the clinical outcomes of primary closure and open techniques in the surgical management of pilonidal sinus. Objective: To compare the clinical outcomes of primary closure and open techniques in the surgical management of pilonidal sinus, focusing on wound healing time, hospitalisation duration, return to work, and postoperative complications. Study Design: Randomized controlled trial. Settings: The study was conducted at a tertiary care hospital. Duration of Study: April 2024 to November 2024 Methods: A total of 60 patients with pilonidal sinus were randomly assigned into two equal groups. Group A underwent excision with primary closure, while Group B underwent excision with the wound left open to heal by secondary intention. Primary outcomes included hospitalization duration, wound healing time, and time to return to work. Secondary outcomes included complications such as wound infection and recurrence. Statistical analysis was performed using appropriate tests, including t-tests and chi-square tests, with p-values ≤ 0.05 considered significant. Results: Group A (primary closure) demonstrated significantly shorter hospitalization (4.37 ± 0.999 vs. 5.80 ± 1.27 days, p < 0.0001), faster wound healing (17.57 ± 1.72 vs. 44.73 ± 3.34 days, p < 0.0001), and earlier return to work (13.60 ± 2.47 vs. 30.43 ± 2.86 days, p < 0.0001) compared to Group B (open technique). Wound infection rates were lower in Group A (6.7%) compared to Group B (23.3%), with a statistically significant difference (p = 0.01). Recurrence rates were also lower in Group A (10.0%) compared to Group B (30.0%). Conclusion: Primary closure is more effective than the open technique in the surgical management of pilonidal sinus, offering faster recovery times, fewer complications, and better overall patient outcomes. When performed appropriately, this technique should be considered the preferred approach for pilonidal sinus surgery.