Crystallized Phenol Treatment Vs Excision and Primary Closure in Pilonidal Sinus Disease: A Randomized Clinical Trial in Adolescent Patients

Introduction: Pilonidal sinus is a chronic inflammatory disease seen in the intergluteal sulcus. A wide variety of treatment modalities have been described for the management of this disease, however opti-mal therapy remains controversial. The study aims to compare phenol treatment, a minimally invasive method used in the treatment of pilonidal sinus disease, with the commonly practiced surgical methods of excision and primary closure in the adolescent age group. Patients and Methods: Adolescent patients who presented with pilonidal sinus disease between January 2018 and December 2018 were randomized into 2 groups as phenol treatment and surgical treatment (af-ter obtaining consent for the study). Early complications and recurrence rates after 24 months of follow-up were the two main endpoints of the study. Results: A total of 100 patients (phenol group n = 50, surgery group n = 50) were included in the study. Both groups were similar in terms of age, gender, and BMI. The mean duration of the procedure was 12.4 +/- 2.84 min in the phenol group and 42.3 +/- 7.22 min in the surgery group ( p = 0.00). There was no difference in postoperative complications between the groups ( p = 0.22). After 24 months of follow-up, recurrence was found in 8% ( n = 4) of the cases in the phenol group and 10% ( n = 5) of the cases in the surgery group ( p = 0.5). Conclusion: In our study, phenol treatment and excision/primary closure methods for pilonidal sinus dis-ease have similar complication and recurrence rates. However, phenol treatment seems to be the method of choice in the adolescent age group as it has the advantage of being a minimally invasive method and it does not affect subsequent surgical treatments. Level of evidence: Level II treatment study (c) 2021 Elsevier Inc. All rights reserved.