STUDY OF THE COMBINATION OF ENDOSCOPIC PILONIDAL SINUS TREATMENT WITH THE USE OF FIBRIN SEALANT

AIM To analyze the advantages of the use of fibrin sealant, applied in the residual cavity, after endoscopic treatment of the pilonidal sinus (EPSIT). BACKGROUND Pilonidal sinus (PS) in the sacroccygeal region is a condition that occurs as an inflammatory response to the incrustation of hair and other debris under the skin in the gluteal cleft. With the advent of endoscopic surgery, postoperative morbidity has been reduced, accelerating the healing process and reintegration into activities of daily living and work. The objective of this study is to demonstrate the effectiveness of using fibrin sealant as filling in the residual cavity after endoscopic treatment. PATIENTS AND METHODS Sixteen (19) patients with an average age of 30.3 years (minimum 17 and maximum 52 years respectively) affected by PS of the sacrococcygeal region were included in this study. All patients underwent surgery with the EPSIT technique, subsequently the sealant containing: human fibrinogen 91 mg1/ml + synthetic aprotinin 3000 UIC2/ml + human thrombin 500 UI3/+ ml was applied. Postoperative pain, analgesic consumption, healing time, time back to work, and postoperative complications were recorded. RESULTS All patients expressed satisfaction with the procedure. Healing was achieved between the 7th and 15th day. The mean postoperative pain score (VAS) was 3 and 16 patients reported taking analgesics during the first 4 days. The average time to return to work was 4 days. 1 patient presented periincisional cellulitis in the immediate postoperative period. CONCLUSION The application of fibrin sealant after EPSIT is an effective treatment and accelerates the healing and return to work process. For these reasons, in our opinion, it should be used in the first line for the treatment of pilonidal sinus.