Pilonidal Sinus Disease: Preliminare Study
Condition: Pilonidal Sinus
MeSH terms: Pilonidal Sinus; Paranasal Sinus Diseases
Study type: Observational [Patient Registry]

Summary: 
      Pilonidal disease is morbid condition of young productive population, that could impair
      quality of life with high cost for health care system. No consensus exists on optimal
      surgical treatment, even if several techniques have been proposed. In this preliminary
      experimental case-control study the investigators compared excision by knife and diathermy
      with the aim to investigate if wound dehiscence could be related to heat spreading during
      excision of the sinus.
    

Detailed description: 
      Between January 2017 and February 2018, 29 patients underwent to sinus excision. The
      investigators considered 16 sinus excision performed by diathermy as a case group (named
      "Hot" group) and the last 13 procedures performed by knife as control group (named "Cold"
      group). Temperature data were recorded for both group. Follow-up was carried out until
      complete healing. Were considered primary and secondary outcomes.
    

Intervention name(s): In "hot" group 16 patients were treated by diathermy in "Cold"; in "Cold" group 13 patients were treated by scalpel.
Intervention type(s): Procedure; Procedure
Intervention description(s): In all interventions, the patients were placed in prone position on operating table with the gluteal line opened wide by adhesive patches; after skin disinfection, dimension and extension of cystic disease was studied by injection of hydrogen peroxide through superficial skin orifice. The same procedure was performed: an elliptical incision on midline around the sinus was made and the sinus was excided laterally and in depth on healthy tissue, down till the pre-sacral fascia: this common approach was made both using scalpel and electrosurgery in the two groups. During dissection and excision, in each group were measured and recorded the temperatures developing, both on the section surface using an infrared thermometer and thermal imaging camera, and deeper until 1 cm from the section frontline using a "immersion thermometer" sealed by a steri-drape to guarantee the sterility on surgical field. In this group excision was carried out with diatermocoagulation; the position and preparation of the patient on the operating table were the same as in the "hot" group, while the excision procedure performed with knife
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        All patients were enrolled by outpatient surgical control for signs and symptoms of chronic
        sinus referred to us by a family doctor; median age was 19.2 ± 4.3 years, ranging from 14
        to 52 years old; 6 patients were females and 23 males and them were request to give
        informed consensus to underwent to pilonidal sinus excision; 16 patients of whom 12 males
        and 4 females, were treated by electrosurgery as case group ("hot"), while in the control
        group ("cold"), 13 patients 11 were male and 2 were females.
      
Keywords: Pilonidal sinus disease; wound deiscence