The use of the CO2 laser in pilonidal sinus disease: preliminary results of an ambulatory prospective study.

During a period of 18 months, from January 1988 to June 1989, 70 patients were treated for pilonidal sinus disease in a Multi-Specialty Military Clinic. There were 62 men and 8 women, with a median age of 19 years (range 18 to 35). All were managed as outpatients under local anesthesia. When an abscess was involved, the surgical procedure included incision, drainage, curettage, peroxide irrigation, and CO2 laser therapy. For the other processes, the surgical procedure included excision of sinus tissue and lateral fistulas, curettage, peroxide irrigation, and CO2 laser therapy with secondary healing. Morbidity was minimal. Healing time ranged from 14 days to 8 weeks, yet most sinuses healed in 4 weeks. The complications observed--pain, bleeding, and skin bridging--were minor. All recurrences but three were minor and healed completely after additional local treatment (4.3 percent major recurrences). Preliminary satisfactory results are reported, supporting a more conservative approach in the treatment of this often overtreated disease.