• Tayeb Kareem.
• Department of Surgery, College of Medicine, Rizgary Teaching Hospital, Hawler Medical University, P.O. Box 0116-09, Erbil, Kurdistan, Iraq. tayebsk@yahoo.com
• World J Surg. 2013 Feb 1; 37 (2): 313-7.

BackgroundThere are different opinions about the treatment of umbilical pilonidal sinus. The aim of the present study was to evaluate the outcome of conservative treatment of this disease.MethodsAll patients with umbilical pilonidal sinus who attended our private surgical clinic in Erbil, Kurdistan, from January 1997 to August 2011, were treated by conservative treatment. Umbilectomy was performed for those who did not respond to the conservative treatment after three sessions.ResultsA total of 134 patients were seen; 121 (90.3 %) were men. Only 105 (78.35 %) patients came back for the second visit. Eighty of them (76.19 %) responded to the treatment. The other 25 (23.8 %) patients were retreated by a second session of conservative treatment. Of these 25 patients, 19 (76 %) came back for the third visit and only three (15.78 %) patients did not respond to the treatment. One patient insisted on umbilectomy. The other two patients were treated but did not respond to the third session treatment. Umbilectomy was performed for them. Hair was found in the sinus after excision in these three patients. The follow-up period ranged from 9 months to 6.5 years for 46 (34.32 %) patients and revealed no recurrence.ConclusionsConservative treatment should be regarded as the first choice and the main method of treatment in the management of umbilical pilonidal sinus. Improper extraction of hair is the main cause of failure of conservative treatment. Recurrence can be prevented by giving the patients instructions on preventive measures.

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