De-roofing and Curettage vs WLE for Pilonidal Abscess
Pilonidal Abscess, Pilonidal Sinus With Abscess, Pilonidal Sinus Infected
About this trial
This is an interventional treatment trial for Pilonidal Abscess focused on measuring Pilonidal abscess, Pilonidal disease, Pilonidal sinus
Eligibility Criteria
Inclusion Criteria:
- All patients with acute pilonidal abscess
Exclusion Criteria:
- Patients under the age of 16 years will be excluded.
- Immunocompromised (diabetes mellitus, taking oral steroids or immunosuppressive medication) patients will be excluded.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Abscess de-roofing and curettage
Abscess wide local excision
Abscess de-roofing and curettage. The patient will be placed in the lateral position with the buttocks spread apart using tape. The cleft of the buttocks will be shaved prior to cleaning and preparation of the skin. A spindle-shaped (elliptical) excision will be performed to the lateral aspect of the abscess formation with a scalpel staying away from the midline. Once the pus has been drained through this lateral incision the wound cavity will then be curetted and washed out with hydrogen peroxide. The wound size will be measured by the operating surgeon who will record the maximal length and width of the wound. Once haemostasis (cessation of any bleeding) is achieved the wound will be packed with Kaltostat ribbon and the wound dressed with blue gauze and mefix tape. The wound is therefore left open.
Wide local excision. Patients will be placed in the prone position with the buttocks spread apart using tape. The cleft of the buttocks will be shaved prior to cleaning and preparation of the skin. Diluted methylene blue will be injected in all visible pits and a wide spindle-shaped (elliptical) midline excision of the skin and the underlying subcutaneous tissue down to the coccygeal (pre-sacral) fascia including all sinuses will be performed with electrocautery. The specimen will be sent for histology as per routine surgical practice. The wound will be washed with hydrogen peroxide. The wound size will be measured by the operating surgeon who will record the maximal length and width of the wound. Once haemostasis (cessation of any bleeding) is achieved the wound will be packed with Kaltostat ribbon and the wound dressed with blue gauze and mefix tape. The wound is therefore left open.