Excision and primary suture of pilonidal sinus.

Pilonidal sinus is a common disabling condition of young adults. Many different operative treatments have been suggested, the ideal treatment is, therefore, controversial. As the recurrence rate for the various procedures is similar, avoidance of a general anesthetic, minimal inpatient stay, and minimal inconvenience and time off work become important considerations. We present our experience with excision and primary closure in 46 patients over a 4-year period. Half the patients had a general anaesthetic, the other half a spinal anaesthetic. Average duration of inpatient stay was 1 day. Early complications (haematoma, wound infection, and minor wound breakdown) occurred in 8%. Early pain was less of a feature after the use of bupivacaine infiltration at the end of the operation. There were 40 patients available for follow-up, with an average of 3 weeks off work and a recurrence rate of 17.5%. Of these patients, three have had the recurrence treated with no further problems.