Irish Journal of Medical Science

, Volume 179, Issue 2, pp 207–210 | Cite as

Incise and lay open: an effective procedure for coccygeal pilonidal sinus disease

  • A. L. GidwaniEmail author
  • K. Murugan
  • A. Nasir
  • R. Brown
Original Article



This study aims to analyze the outcome of various procedures performed for coccygeal pilonidal disease.


Between January 1999 and February 2004, patients with coccygeal pilonidal disease were included. Data were analyzed for the nature of operation (elective/emergency), grade of surgeon, type of procedure and further definitive surgery.


Two hundred and four patients underwent surgery for coccygeal pilonidal disease. One hundred and thirty-six patients had emergency surgery (abscess drainage: 61; abscess drainage + lay open: 75) and further definitive procedure was performed in 20 (33.3%) and 8 (11.1%) patients, respectively (P = 0.013, Fishers' exact test). Sixty-eight patients had elective surgery (incision and lay open: 34; excision and lay open: 24; excision and closure/Bascom’s/other: 10) and further procedure for recurrence was noted among 3 (8.8%), 5 (20.8%) and 4 (40%) patients, respectively (P = 0.17, χ2 test).


In patients with coccygeal pilonidal sinus disease, a single-stage incision and lay open of the sinus tract is the most efficient operation, especially during emergency surgery.


Pilonidal sinus Abscess Incision Lay open Emergency/elective 


  1. 1.
    Mayo H (1833) Observation in injuries and diseases of the rectum. Burgess and Hill, LondonGoogle Scholar
  2. 2.
    Hodges RM (1880) Pilonidal sinus. Boston Med Surg J 103:485–486Google Scholar
  3. 3.
    Franckowiak JJ, Jackman RJ (1962) The etiology of pilonidal sinus. Dis Colon Rectum 5:28–36. doi: 10.1007/BF02616408 CrossRefPubMedGoogle Scholar
  4. 4.
    Sondenaa K, Andersen E, Nesvik I, Soreide JA (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Colorectal Dis 10:39–42. doi: 10.1007/BF00337585 CrossRefGoogle Scholar
  5. 5.
    Solla JA, Rothenberger DA (1990) Chronic pilonidal disease: an assessment of 150 cases. Dis Colon Rectum 33:758–761. doi: 10.1007/BF02052321 CrossRefPubMedGoogle Scholar
  6. 6.
    Goodall O (1961) The etiology and treatment of pilonidal sinus: a review of 163 patients. Br J Surg 49:212–218. doi: 10.1002/bjs.18004921421 CrossRefPubMedGoogle Scholar
  7. 7.
    Allen-Mersh TG (1990) Pilonidal sinus: finding the right track for treatment. Br J Surg 77(2):123–132. doi: 10.1002/bjs.1800770203 CrossRefPubMedGoogle Scholar
  8. 8.
    Obeid SA (1988) A new technique for treatment of pilonidal sinus. Dis Colon Rectum 31:879–885. doi: 10.1007/BF02554854 CrossRefPubMedGoogle Scholar
  9. 9.
    Akinci OF, Coskun A, Uzunkoy A (2000) Simple and effective surgical treatment of pilonidal sinus. Dis Colon Rectum 43:701–706. doi: 10.1007/BF02235591 CrossRefPubMedGoogle Scholar
  10. 10.
    Maurice BA, Greenwood RK (1964) A conservative treatment of pilonidal sinus. Br J Surg 51:510–512. doi: 10.1002/bjs.1800510711 CrossRefPubMedGoogle Scholar
  11. 11.
    Mansoory A, Dickson D (1982) A plasty for treatment of pilonidal sinus. Surg Gynecol Obstet 155:409–411PubMedGoogle Scholar
  12. 12.
    Isbister WH, Prasad J (1995) Pilonidal disease. Aust N Z J Surg 65(8):561–563. doi: 10.1111/j.1445-2197.1995.tb01695.x CrossRefPubMedGoogle Scholar
  13. 13.
    Al-Homoud SJ, Habib ZS, Abdul Jabbar AS, Isbister WH (2001) Management of sacrococcygeal pilonidal disease. Saudi Med J 22(9):762–764PubMedGoogle Scholar
  14. 14.
    Weinsterin MA, Rubin RJ, Salvati EP (1977) The dilemma of pilonidal disease: pilonidal cystostomy, reappraisal of an old technique. Dis Colon Rectum 20:287–289. doi: 10.1007/BF02586424 CrossRefGoogle Scholar
  15. 15.
    Sondenna K, Diab R, Nesvik I, Gullaksen FP, Kristiansen RM, Saebo A, Komer H (2002) Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. Combined prospective study and randomized controlled trial. Eur J Surg 168:614–618. doi: 10.1080/11024150201680007 CrossRefGoogle Scholar
  16. 16.
    Bascom J (1983) Pilonidal disease: long-term results of follicle removal. Dis Colon Rectum 26:800–807. doi: 10.1007/BF02554755 CrossRefPubMedGoogle Scholar
  17. 17.
    Senapati A, Cripps NP, Thompson MR (2000) Bascom’s operation in the day-surgical management of symptomatic pilonidal sinus. Br J Surg 87(8):1067–1070. doi: 10.1046/j.1365-2168.2000.01472.x CrossRefPubMedGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2009

Authors and Affiliations

  • A. L. Gidwani
    • 1
    • 2
    Email author
  • K. Murugan
    • 1
  • A. Nasir
    • 1
  • R. Brown
    • 1
  1. 1.Department of SurgeryDaisy Hill HospitalNewryNorthern Ireland, UK
  2. 2.Department of SurgeryAltnagelvin Area HospitalLondonderryNorthern Ireland, UK

Personalised recommendations