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Minimally Invasive Treatment of Pilonidal Disease with a Flowable Soft-Tissue Scaffold
James R Piorkowski1, James Matino2
1University of Connecticut, Farmington, CT;2Saint Francis Hospital and Medical Center, Hartford, CT
Objective: Full thickness excision of the gluteal cleft with immediate closure or flap rotation is commonly used to treat non-infected pilonidal sinus disease. Treatment is often painful, requires time off from work or school, and is frequently plagued with wound related morbidity. We hypothesized that patients treated by the author’s novel technique have minimal pain, a short recovery time, and an acceptable rate of wound related morbidity.
Design: Prospective cohort study
Setting:Tertiary care, university affiliated hospital
Patients: Fifteen consecutive patients with chronic non-infected pilonidal disease were consented and treated using the author’s novel technique.
Interventions: Patients underwent fine excision of the sinus pores and curettage of the sinus tracks. Tracks were then injected with Graft Jacket Xpress flowable soft-tissue scaffold(Wright Medical Tech. Arlington, TN). Procedures were performed in an ambulatory surgery setting.
Main Outcome Measures: Pain medication requirements, time off from work or school, infection, healing time, and recurrence.
Results: 2 patients required oral pain medications. There was no time lost from work or school except for the day of surgery. There were no wound infections. 2 patients(13.3%) had wound failure/recurrence during a follow up period ranging from 6-13months. 69% of wounds were healed within 3 weeks of surgery and 100% within 6 weeks of surgery.
Conclusions: In this pilot study using the author’s novel technique, patients had very little postoperative pain, an early return to normal activity, and an acceptable rate of pilonidal recurrence.
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