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HNO 1. August 2011

Does gentamycin affect long term recurrence rate in pilonidal sinus surgery?

BACKGROUND: The influence of topical intraoperative gentamycin on long term recurrence rate in primary pilonidal sinus surgery has not yet been investigated. METHODS: One hundred and eight-seven patients following excision of primary pilonidal sinus disease (PSD) and primary symmetrical midline closure were analysed regarding the use (group 1) or non-use (group 2) of topical application of an intraoperative gentamycin sponge after a median follow-up of 16 years by a specific questionnaire. RESULTS: The actuarial 15-year-recurrence rate in group 1 was 31% (34/111) compared to 26% (20/76) in group 2, which was statistically not different (p = 0.99). Recurrences occurred with a median 2.7 (range 0.1–20.1) years after primary surgery, so time to recurrence did not differ between both groups (4.3 ± 0.8 years group 1 vs. 6.8 ± 1.5 years group 2; p = 0.99). CONCLUSIONS: The suggested positive effects of topical gentamycin application on long term recurrence rate could not be confirmed. Astonishingly though, surgical infection does not seem to alter long term recurrence rate.

D. Doll, T. Evers, E. Matevossian, S. Hoffmann, B. Krapohl, D. Bartsch, European Surgery 4/2011

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