Role of Deep Tension Sutures in Closing the Defect Following Excision of Sacrococcygeal Pilonidal Sinus – A Case Series

• Main Authors: N Thulasivasudevaiah, S Sudhir, P Deepak Naik, D K Dilip, Ankit Raj, Sujitkumar Sah
• Format: Article
• Language: English
• Published: ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES 2020-06-01
• Series: Journal of Medical Sciences and Health
• Subjects: deep tension sutures; pilonidal; sacrococcygeal.
• Online Access: http://jmsh.ac.in/index.php?option=com_k2&view=item&id=138:role-of-deep-tension-sutures-in-closing-the-defect-following-excision-of-sacrococcygeal-pilonidal-sinus-%E2%80%93-a-case-series&Itemid=1

Background: The midline sacrococcygeal pilonidal sinus is the common surgical condition among younger population. They present to surgical outpatient department with pain and history of pus discharge from natal cleft. These patients approach for permanent cure following repeated attacks of pain and abscess drainage. We present a new surgical technique of primary closure by applying deep tension sutures (DTS) to close the defect following excision of midline sacrococcygeal pilonidal sinus. The rationale behind this technique is to avoid prolonged hospital stay and early return to work. Materials and Methods: In this study, a group of five patients (one female and four male patients) with the age group between 18 and 35 years was studied for the effectiveness, duration of hospital stay post-operative complications, and recurrence following the new surgical technique of DTS. Following excision of midline sacral pilonidal sinus, the resulting elliptical wound varying from 6 cm to 10 cm was approximated using two or three DTS with No-1 Prolene. In this suturing technique, the sutures were held in place using small pieces of plastic tubing from intravenous drip set to avoid suture cutting through the skin. This technique was similar to abdominal wound closure in cases of complete wound dehiscence. The superficial part of the wound was approximated using No-3 zero Ethilon. In this procedure, author has not used any type of drain in the wound. No suture materials were used inside the wound to approximate the raw area (e.g., Vicryl suture). Patients were covered with IV antibiotics and analgesics for a period of 5 days. All sutures were removed on the 10th day. Results: There were no post-operative complications noted during the hospital stay and during follow-up period ranging from 2 months to 6 months. The scar was healthy with functionally, cosmetically acceptable results. There was no recurrence noted in our study group during the follow-up.