Bacteriology and complications of chronic pilonidal sinus treated with excision and primary suture

Two prospective studies were undertaken to examine the role of bacteria in the outcome after excision and primary suture for chronic pilonidal sinus disease. In the first study 52 consecutive patients were given cloxacillin as prophylaxis. In a second randomised study 51 patients were given 2 g cefo...

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Bibliographic Details
Published in:International journal of colorectal disease 1995-07, Vol.10 (3), p.161-166
Main Authors: SØNDENAA, K, NESVIK, I, ANDERSEN, E, NATAS, O, SØREIDE, J. A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antibiotic Prophylaxis
Bacteria - isolation & purification
Biological and medical sciences
Cefoxitin - therapeutic use
Child
Chronic Disease
Cloxacillin - therapeutic use
Dermatology
Female
Hair and nails disorders
Humans
Male
Medical sciences
Microbial Sensitivity Tests
Middle Aged
Pilonidal Sinus - microbiology
Pilonidal Sinus - surgery
Postoperative Complications
Prospective Studies
Recurrence
Surgical Wound Infection - microbiology
Surgical Wound Infection - prevention & control
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Summary:Two prospective studies were undertaken to examine the role of bacteria in the outcome after excision and primary suture for chronic pilonidal sinus disease. In the first study 52 consecutive patients were given cloxacillin as prophylaxis. In a second randomised study 51 patients were given 2 g cefoxitin intravenously (n = 25) or no prophylaxis (n = 26). From 49 out of 98 patients (50%) no microorganisms were isolated from sinuses preoperatively. Wound complications were observed postoperatively in 61% of the patients (63/103). A postoperative bacteriology sample was positive in 47 of 49 samples (96%). Preoperative presence of bacteria was not significantly associated with wound complications. Anaerobe isolates were present in 40% of patients preoperatively whereas aerobes were cultured in 43% postoperatively. After an observation period of 30-42 months, recurrences were 13% among the patients (7/52) who had been given cloxacillin. No recurrences were seen in the last study after an observation period of 18-30 months, for an overall 7% in both studies. We conclude that preoperative bacterial isolates, usually anaerobes, in chronic pilonidal sinuses do not influence the complication rate since bacterial isolates from infected wounds are mostly aerobes.
ISSN:0179-1958
1432-1262
DOI:10.1007/BF00298540