Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus.

OBJECTIVE

To assess the efficacy of hydrocolloid dressings in wound management after excision of pilonidal sinus.

DESIGN

Prospective randomised trial.

SETTING

District hospital, Spain.

PATIENTS

38 patients with chronic pilonidal sinus.

INTERVENTIONS

Open excision with healing by second intention. Divided into three groups: conventional gauze dressing (control, n = 15), Comfeel (n = 12) and Varihesive (n = 11).

MAIN OUTCOME MEASURES

Median healing time, infection rate, intolerance, pain, comfort, ease of management, leakage, and recurrence.

RESULTS

Median healing time was 68 days (range 33-168) in the control group, compared with 65 days (range 40-137) in the two hydrocolloid groups combined. There were no differences between the hydrocolloid groups. There were no recurrences during the 74 months of follow-up. A third of the postoperative cultures in the control group grew pathogens compared with 1/23 of the patients treated with hydrocolloid dressings (p = 0.03). This was of no clinical relevance. 14/23 in the hydrocolloid group developed leaks. Pain was significantly less in the first four postoperative weeks among the patients in the hydrocolloid group than in the control group (p < 0.05).

CONCLUSIONS

Hydrocolloid dressings lessen pain and increase comfort for patients after excision of pilonidal sinus, though time to healing is no shorten than when a conventional gauze dressing is used.