Acta chirurgica Scandinavica
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Randomized Controlled Trial Comparative Study Clinical Trial
Primary closure or secondary granulation after excision of pilonidal sinus?
Two methods for treatment of chronic pilonidal disease were compared in a randomised trial of 100 patients with a mean follow-up of 29 months. Four patients were excluded from the excision and closure group, leaving 96 patients for analysis. Initial primary healing was significantly more frequent after excision and primary closure (45/46; 98%) compared with excision and healing by secondary granulation (36/50; 72%). ⋯ The presence of stiff hair and anaerobic bacteria were related to the failure of primary healing, but not associated with recurrence. Although the cure rate was the same regardless which operation was done, the primary healing was quicker and the healing time and duration of sick-leave were shorter after primary closure. Excision with primary closure therefore seems to be the preferable method.
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A 37-year-old woman presented with hoarseness two days after developing pain while undergoing physiotherapy for tension in her neck. Computed tomography showed a probably benign mass near to the left lobe of the thyroid, which was found at operation to be attached to the recurrent laryngeal nerve. The nerve was dissected free, the tumour removed, and the patient and her voice recovered fully. Histological examination confirmed a benign cyst in extraglandular thyroid tissue and the patient is well two years later.