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Chirurgie 12. September 2014

The effect of using methylene blue in surgical treatments of pilonidal disease: a prospective randomized study

Objectives: The aim of this study was to examine the effect of using intraoperative methylene blue (MB) in the treatment of pilonidal disease in the Karydakis flap practice on wound infection and recurrence and also by investigating other factors that affect wound infection and recurrence.

Patients and methods: In our research, the data of 231 patients, 129 of whom were in the MB [+] group and 102 of whom were in the MB [−] group, were obtained. Each patient’s age, gender, body mass index, whether they underwent pilonidal sinus surgery previously, the number of primary orifices, the number of secondary orifices, any preoperative infection, abscess drainage, and the use of antibiotic, if any, were recorded.

Results: The rate of postoperative wound infection in the entire group was found to be 25.1 %. While 19.4 % of the patients in MB [+] group had a wound infection, 32.4 % of the patients in the MB [−] group had a wound infection. The usage of MB was found to be a preventing factor in the occurrence of wound infection (p = 0.024).

Conclusion: MB is beneficial owing to its reducing effect on wound infections, which in turn is associated with a lower recurrence rate and a fast postoperative recovery. We suggest the use of MB at the beginning of acute or chronic pilonidal sinus surgeries, as MB is nontoxic and is of very low cost.

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