Slovenská chirurgia 4/2017
Outpatient treatment of recurrent pilonidal sinus by cutting elastic ligature
Cutting elastic ligature (seton) as a simple outpatient surgical procedure enables the definitive treatment of recurrent pilonidal sinus, which occurred after the complete conventional surgical excision of primary pilonidal sinus. 20 patients with recurrent pilonidal sinus (RPS) were treated as outpatients under local anaesthetic by cutting elastic ligature. The cutting elastic ligature passes through the tract of recurrent pilonidal fistula by its caudal entrance and cranial outgoing opening and at once under the scar. As a consequence it drains a pathological tract, accomplishes gradual and gentle fistulotomy and cicatricotomy. Controlled process of granulation and epitelization enables to adapt postoperative skin and subcutaneous deformations of sacro-coccygeal area, which are important patogenetic factor of the occurrence of RPS. Cutting elastic ligature enables the definitive treatment of RPS outpatiently, with patient’s full working ability and minimal discomfort. Its application can be preferred to a repetitive hospitalisation and next conventional surgical excision.
Keywords: recurrent pilonidal sinus, scar of sacro-coccygeal area, outpatient treatment, cutting elastic ligature
