Abstract:
To review the current data about the success rates of fibrin sealant use in pilonidal disease.
METHODS: Fibrin sealant can be used for different
purposes in pilonidal sinus treatment, such as filling in
the sinus tracts, covering the open wound after excision
and lay-open treatment, or obliterating the subcutaneous
dead space before skin closure. We searched Pubmed,
Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane
databases and found nine studies eligible for analysis;
these studies included a total of 217 patients (84%
male, mean age 24.2 ± 7.8).
RESULTS: In cases where fibrin sealant was used to
obliterate the subcutaneous dead space, there was no
reduction in wound complication rates (9.8% vs 14.6%,
P = 0.48). In cases where sealant was used to cover
the laid-open area, the wound healing time and patient
comfort were reported better than in previous studies
(mean 17 d, 88% satisfaction). When fibrin sealant was
used to fill the sinus tracts, the recurrence rate was
around 20%, despite the highly selected grouping of
patients.
CONCLUSION: Consequently, using fibrin sealant to
decrease the risk of seroma formation was determined
to be an ineffective course of action. It was not advisable
to fill the sinus tracts with fibrin sealant because it
was not superior to other cost-effective and minimally
invasive treatments. New comparative studies can
be conducted to confirm the results of sealant use in
covering the laid-open area.
