06.04 Negative Pressure Wound Therapy is Beneficial in the Treatment of Pilonidal Disease

Posted on January 31, 2019

E. Bianchi1, T. Adegboyega1, S. Shih1, C. Zhang1, D. E. Rivadeneira1  1Huntington Hospital/Northwell Health,Colon & Rectal Surgery,Huntington, NY, USA

Introduction:  

There are multiple surgical approaches to the treatment of Pilonidal Sinus Disease (PSD). All are associated with wound complications including surgical site infections (SSI), dehiscence, and recurrence. Negative Pressure Wound Therapy (NPWT) has been reported to decrease wound complications after surgery.  We report our experience with NPWT after excision with primary closure of PSD

Methods:
We report 65 consecutive patients that underwent excision of pilonidal sinus disease with primary closure and placement of Negative Pressure Wound Therapy dressing. NPWT was places over the closed incision for 3-7 days at -120mm hg. We compare these results with 65 patients consecutive patients prior to using NPWT who underwent excision PSD with primary closure. Both groups studied where well matched and there was no difference in Age, sex, OR time, Blood loss, incisions size. Early period complications (wound site infection, wound dehiscence, abscess, hematoma and seroma formation) developing within 30 days of operation was recorded from the medical files. Data were analyzed using SPSS ver. 12.0 (SPSS Inc., Chicago, IL, USA). Comparison of groups was done with ANOVA

Results:

Mean age of patients was 25.4 ± 5.7 years and the male: female ratio was 4:1. Operation time did not differ between groups. Significant decrease in early wound complications occurred in those patients treated with NPWT, 11% (6/65,) compared to those patients that did not have NPWT, 25% (16/65) p, <0.001.  Surgical site infection was significantly decreased in the NPWT group, 4.6% (3/65) compared to those who did not have NPWT 15% (10/65), p<0.001.  Recurrence of pilonidal disease was significantly decreased in the NPWT patients 3% (2/65) compared to non-NPWT 12% (8/65), p<0.0001.

Conclusion:

The use of negative pressure wound therapy (NPWT) is beneficial in patients undergoing excision and primary closure of pilonidal sinus disease. NPWT leads to a decrease in early wound complications including wound seroma, dehiscence and SSI. In addition NPWT also significantly resulted in a decrease in recurrence of disease.We recommend the use of NPWT in the surgical management of pilonidal disease.