Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus

Abstract

Objective: To assess the efficacy of hydrocolloid dressings in wound management after excision of pilonidal sinus. Design: Prospective randomised trial. Setting: District hospital, Spain. Patients: 38 patients with chronic pilonidal sinus. Interventions: Open excision with healing by second intention. Divided into three groups: conventional gauze dressing (control, n = 15), Comfeel® (n = 12) and Varihesive® (n = 11) Main outcome measures: Median healing time, infection rate, intolerance, pain, comfort, ease of management, leakage, and recurrence. Results: Median healing time was 68 days (range 33-168) in the control group, compared with 65 days (range 40-137) in the two hydrocolloid groups combined. There were no differences between the hydrocolloid groups. There were no recurrences during the 74 months of follow-up. A third of the postoperative cultures in the control group grew pathogens compared with 1/23 of the patients treated with hydrocolloid dressings (p = 0.03). This was of no clinical relevance. 14/23 in the hydrocolloid group developed leaks. Pain was significantly less in the first four postoperative weeks among the patients in the hydrocolloid group than in the control group (p < 0.05). Conclusions: Hydrocolloid dressings lessen pain and increase comfort for patients after excision of pilonidal sinus, though time to healing is no shorten than when a conventional gauze dressing is used.