Short convalescence and minimal pain after out-patient Bascom's pit-pick operation

Abstract

Introduction: Treatment of pilonidal sinuses with Bascom's pit-pick operation can easily be performed under local analgesia. We describe pain during and after the operation, time to return to work, time to healing and success rate.

Material and methods: The study comprised a cohort of 75 primary pit-pick (PP) operations performed at our department between August 2007 and December 2009. The median age was 30 years (range 15-64 years) and 57 (76%) were male. A total of 55 patients were interviewed daily by phone for one week with a view to registering their ability to return to work and their scoring of maximum pain on a numerical rating scale with a pain score ranging from 0 (no pain) to 10.

Results: The mean maximum pain during the first post-operative day was 2.2 (95% confidence interval (CI) 1.8-2.7) and at day four 1.0 (CI 0.7-1.3). Within 24 hours, 51% could return to work and the mean time was 3.2 (CI 1.8-4.5) days. Postoperative infection was related to the presence of secondary sinus (p = 0.03) and increasing number of midline sinus excisions (p = 0.02). Complete wound healing was achieved in 84% of the patients after a mean period of 3.5 (CI 3.1-3.9) weeks. Incomplete wound healing was significantly related to a small number of PPs (p < 0.05), increasing number of midline sinus excisions (p < 0.05) and no postoperative infection (p = 0.01). At one-year follow-up 80% were considered successfully treated.

Conclusion: The majority of patients with simple pilonidal sinuses can be treated successfully with Bascom's PP procedure as out-patients. This regimen causes only mild postoperative pain and patients can resume work after a few days.

Funding: not relevant.

Trial registration: not relevant.