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World Journal of Surgery

, Volume 35, Issue 1, pp 206–211 | Cite as

Wound Infection After Excision and Primary Midline Closure for Pilonidal Disease: Risk Factor Analysis to Improve Patient Selection

  • Sotirios Popeskou
  • Dimitrios ChristoforidisEmail author
  • Christiane Ruffieux
  • Nicolas Demartines
Article

Abstract

Background

Excision and primary midline closure for pilonidal disease (PD) is a simple procedure; however, it is frequently complicated by infection and prolonged healing. The aim of this study was to analyze risk factors for surgical site infection (SSI) in this context.

Methods

All consecutive patients undergoing excision and primary closure for PD from January 2002 through October 2008 were retrospectively assessed. The end points were SSI, as defined by the Center for Disease Control, and time to healing. Univariable and multivariable risk factor analyses were performed.

Results

One hundred thirty-one patients were included [97 men (74%), median age = 24 (range 15-66) years]. SSI occurred in 41 (31%) patients. Median time to healing was 20 days (range 12-76) in patients without SSI and 62 days (range 20-176) in patients with SSI (P < 0.0001). In univariable and multivariable analyses, smoking [OR = 2.6 (95% CI 1.02, 6.8), P = 0.046] and lack of antibiotic prophylaxis [OR = 5.6 (95% CI 2.5, 14.3), P = 0.001] were significant predictors for SSI. Adjusted for SSI, age over 25 was a significant predictor of prolonged healing.

Conclusion

This study suggests that the rate of SSI after excision and primary closure of PD is higher in smokers and could be reduced by antibiotic prophylaxis. SSI significantly prolongs healing time, particularly in patients over 25 years.

Keywords

Methylene Blue Antibiotic Prophylaxis Primary Closure Hidradenitis Suppurativa Pilonidal Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Sotirios Popeskou
    • 1
  • Dimitrios Christoforidis
    • 1
    • 3
    Email author
  • Christiane Ruffieux
    • 2
  • Nicolas Demartines
    • 1
  1. 1.Division of Visceral Surgery, Department of SurgeryCHUV, University of LausanneLausanneSwitzerland
  2. 2.Institute of Preventive and Social Medicine, BiostatisticsUniversity of LausanneLausanneSwitzerland
  3. 3.Service de Chirurgie Viscérale, BH 15 CHUVLausanneSwitzerland

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