Comparison between the tie-over and Karydakis procedure in chronic sacrococcygeal pilonidal sinus

Background and aims: Pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort forthe patient. Although there are various therapeutic modalities to manage these patients, there is still controversy about choosing the bestsurgical technique to decrease the recurrence rate, patient discomfort, and duration of disability after surgery. The present study aimed tocompare the results obtained from two surgery methods including tie-over procedure (TOP) and Karydakis procedure (KP) for the treatmentof sacrococcygeal pilonidal sinus.Methods: In this single-blind clinical trial, ۷۰ patients with the diagnosis of pilonidal sinus disease were divided into two equal groups(n=۳۵ each) and treated randomly with surgical excision and TOP or KP by the same surgeon in the Kashani educational hospital inShahrekord, Iran from ۲۰۰۹ and ۲۰۱۱. The patients were followed up until December ۲۰۱۹.Results: According to the results, after excision of sacrococcygeal pilonidal sinus, the primary closure of the wound by tie-over sutures hadbetter results than KP in order of pain sore during the first month after surgery (P < ۰.۰۰۱), duration of disability (P < ۰.۰۰۱), wound repairtime (P < ۰.۰۰۱), and patient satisfaction (P = ۰.۰۱۹).Conclusion: Our results showed TOP was a better procedure compared to KP for the treatment of chronic pilonidal sinus due to higheracceptance results in patients undergoing surgery.

Keywords:

Sacrococcygeal pilonidal sinus , Suture techniques , Karydakis procedure , Tie-over procedure , Wound healing