Comparison of the Effectiveness of the Simple Puncture Compared to the Incision of an Abscess on the PiLOnidal Sinus

Summary

Pilonidal disease is a common disease characterized by the presence of abscess in the intergluteal groove. During periods of abscess, current recommendations are to make a simple incision with daily wicking of the abscess. Direct excision at this time is not recommended because there is a risk of incomplete excision. The principle of directed healing after incision of the abscess results in an average dressing period of 21 days. A definitive resection is recommended after 4 to 6 weeks, when healing has been achieved, in order to limit the risk of infectious recurrence. An alternative has recently been proposed, consisting of a puncture of the abscess, aimed at emptying it under antibiotic coverage. The major advantage of this treatment is that patients no longer need general anesthesia to flatten the abscess. Although this technique is promising, it is currently not the subject of any published or ongoing randomized controlled study registered on Clinicaltrials.gov. The research hypothesis is that the two techniques have the same results in terms of recurrence before definitive surgical treatment but that drainage puncture would imply a faster healing time, a lower cost of treatment, a quality of superior support, reduced support time and reduced work stoppage.

Eligibility

Inclusion Criteria:

* Adult patients with a pilonidal sinus abscess
* Surgical indication for flattening the abscess
* Recurrent or de novo abscess
* Signature of consent to participate in the study

Exclusion Criteria:

* Antibiotic therapy initiated before the emergency room consultation or before the scheduled consultation
* Skin necrosis
* Immunosuppression (drug-related or pathological) or diabetes
* Spontaneous fistulization
* Patients who do not speak French
* Pregnant and/or breastfeeding women
* Patients without social security coverage
* Person deprived of liberty by judicial or administrative decision
* Person subject to psychiatric care under duress
* Person subject to a legal protection measure
* Person unable to express consent

Conditions2

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