Ambulatory Surgery for Pilonidal Sinus : Tract Excision and Open Treatment Followed by At-Home Irrigation

Pilonidal sinus is a cystic disease that occurs most often in the sacrococcygeal region. Surgical excision and coverage with a skin flap require postoperative bed rest. Most affected patients are young adults who find it difficult to obtain adequate postoperative bed rest owing to their work. The purpose of this study is to review the effectiveness of our ambulatory surgery procedure for pilonidal sinus, which involves tract excision and open treatment followed by at-home irrigation. We reviewed the 9 cases of chronic pilonidal sinus treated at our out-patient clinic by ambulatory surgery consisting of open excision without skin closure. Patients were sent home after careful observation for hemostasis at the surgical site. Postoperative wound treatment and irrigation were performed at home by the patients themselves. The mean immediate postoperative follow-up period was 22.3 days (13 to 31 days), and the mean number of follow-up visits was 3.3. No serious complication and recurrence was noted during the long-term follow-up period of 26.3 months (1 to 60 months). Although the healing time following our ambulatory procedure was not short, no postoperative rest was required, and the recurrence rate was zero. We believe this procedure is useful for selected patients with pilonidal sinus.