Comparison of Complete Sinus Excision and Reconstruction with Sinus Excision and Umbilical Preservation for Treatment of Umbilical Pilonidal Sinus

Abstract

Background: Umbilical pilonidal sinus is a granulomatous reaction to hair shaft penetrating the epidermis of umbilicus from the external surface. In this study, the outcome of complete excision of the umbilical sinus with umbilical reconstruction and sinus excision with umbilical preservation is considered.
Methods: This study was a clinical trial. In this study, 60 subjects with umbilical pilonidal sinus were enrolled  into two groups (Group I, complete excision of the umbilical sinus with umbilical reconstruction, n = 30, Group II, sinus excision with umbilical preservation n = 30). Discharge, bulging, pain, bleeding, and itching of umbilicus and existence of hair were registered in the base visit and then 1 and 2 weeks, and 1, 3, and 6 monthslater. Patients with umbilical pilonidal sinus, who had not undergone any previous surgeries, were operated on using a technique that involves complete excision of the umbilical sinus followed by reconstruction of the umbilicus or sinus excision with umbilical preservation. Patients were then followed and wound complications,and recurrence were evaluated at post-operative visits (1 week, 2 weeks, 1 month, 3 months, and 6 months later). Remission and relapse of each symptom were compared. Data were analyzed by SPSS version 16.
Results: A total of 60 patients underwent the operation; 55 (91.7%) were male, and 5 (8.3%) were female. The mean age in Group I, complete excision of the umbilical sinus with umbilical reconstruction was 29.9 years (18-45 years) and mean age of Group II, sinus excision with umbilical preservation was 28 years (19-42). Themean follow-up period was ٦ months. Only one patient in Group I, complete excision of the umbilical sinus with umbilical reconstruction had seroma and hyperemia of the skin after the operation, and treated  conservatively at an outpatient clinic. No recurrence was observed during the follow-up period, and the most patients were satisfied with the appearance of their umbilicus. The two groups were not different by the meansof age, sex and symptoms at baseline (P > 0.050). Remission of symptoms were not significantly different inthe two groups (P > 0.050). The probability of relapse of other symptoms were not different in two groups (P > 0.050).
Conclusions: Umbilical sinus excision with umbilical reconstruction is a relatively simple and effectivesurgical option for treating umbilical pilonidal disease with acceptable patient satisfaction and no serious complications. It may also be associated with a low risk of recurrence.