Abstract
Objective: To assess the outcome of pilonidal sinus primary repair compared to healing by second intention as shown by wound healing time, return to work time and recurrence.
Methodology: 50 patients were selected and randomised through random table generation. There were 30 patients in primary repair group (Group 1) and 20 patients in healing by second intention (Group 2). Patients were followed for up to one year postoperatively. Length of stay, time of return to work, wound healing rate, recurrence and occurrence of early postoperative complications were recorded.
Results: The mean return to work time, and mean total healing time was significantly lower for primary repair than for open healing group (t (-4.7), p <0.001, mean difference: -9.7; 95% CI, -13.78 to -5.61 for return to work time and t(-16.17), p <0.001 mean difference; -45.45, 95% CI, -51.10 to -39.80 for total healing time, respectively). However, the mean difference for length of stay was not significant between the two treatment groups (t(-1.23), p=0.224, mean difference: -0.75, 95% CI, -1.97 to 0.47). The occurrence of complications in primary repair group was more frequent, U=234, z=-2.16, p=0.030.
Conclusion: Primary repair confers rapid healing rates, with early return to work, however, wound complications were more frequent. Open healing technique is safer with respect to lower recurrence rates and low incidence of wound complications.

Key words: Pilonidal sinus, surgical outcome, open healing, primary closure