Effectiveness of collagenase in the treatment of sacrococcygeal pilonidal sinus disease

Purpose. Sacrococcygeal pilonidal sinus disease (SPSD) is a disease affecting young patients, which results in a long-term loss of productive power, and also tends to have high rates of morbidity since it has no ideal treatment. The main purpose of this study was to investigate the effectiveness of topical collagenase in the treatment of SPSD. Methods. In the present study, 40 patients admitted to our department were separated into two groups. Excision and marsupialization with dressing by bacterial collagenase was performed in the first group, while the treatment was excision and marsupialization without dressing by bacterial collagenase in the second group. Results. We determined that the healing in terms of the width and depth of the wound in the first week and in depth of wound in the second week was better in group I than in group 2 (P = 0.040, P = 0.020, P = 0.048, respectively). The duration of wound healing was 21.9 +/- 1.3 days in group 1, and 28.1 +/- 1.3 days in group 2 (P = 0.0001). The recurrence rate in the intergluteal area, which heals by granulation and has no hair follicles, tends to decrease when a partial closure is obtained. Conclusion. We therefore recommend an excision, marsupialization, and dressing with bacterial collagenase, in cases with noncomplicated SPSD.