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Bader Shirah1, Hamza Shirah2

1) King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia;

2) Department of General Surgery, Al Ansar General Hospital, Medina, Saudi Arabia.

Disclosure: The author has declared no conflicts of interest.

Received: 16.12.15 Accepted: 04.01.16

1486385429 Quote  doi: 10.5455/ijsm.woundhealing

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Many clinical studies reported excellent results when the lay open method was used as a treatment of chronic sacrococcygeal pilonidal sinus, despite leaving the wound open for long time, and the increased risk of infection and recurrence.In our study, we aim to analyze the effectiveness of Hydrogen Peroxide use in the postoperative care of the laid open sacrococcygeal pilonidal wound regarding wound infection, healing, and recurrence.
Methods: 500 patients with chronic sacrococcygeal pilonidal sinus were included in our study. 383 were male, and 117 were female (age range, 16–39). Lay open was performed to all patients. 250 patients accepted the protocol of Hydrogen Peroxide wound care, the other 250 patients preferred normal saline wound care. Postoperative follow-up methods were similar to all patients.
Results: Recurrence rate was 0% after five years of follow-up for the lay open technique in all 250 patients in the H2O2 group, and 2% in the normal saline group. Postoperative wound infection rate was 3.2% in the H2O2 group compared to 19.2% in the normal saline group, and the average healing time for the H2O2 group was 21 days while in the normal saline group was 28 days.
Conclusion: We conclude when 3% Hydrogen Peroxide is used for cleaning the laid open wound in treating chronic sacrococcygeal pilonidal sinus, with good postoperative care, and regular follow-up, is effective in helping to achieve a zero (0%) recurrence rate, low wound infection rate, and short healing time.

Keywords: lay open, wound infection, sacrococcygeal pilonidal sinus, hydrogen peroxide, normal saline


1. John Bascom. Surgical treatment of pilonidal disease. BMJ. 2008 Apr 19; 336(7649): 842-843.
2. Harlak A, Mentes O, Ozer MT, Ersoz N, and Coskun AK. Evaluation of history and physical examination data of 587 patients with the sacrococcygeal pilonidal disease. Eurasian J Med 2006. 38 (3):103-106.
3. Kaymakcioglu N, Yagci G, Simsek A, Unlu A, Tekin OF, Cetiner S, et al. Treatment of pilonidal sinus by phenol application and factors affecting the recurrence. Tech Coloproctol 2005. 9 (1):21-24.
4. Lee HC, Ho YH, Seow CF, Eu KW, and Nyam D. Pilonidal disease in Singapore: clinical features and management. Aust N Z J Surg 2000. 70 (3):196-198.
5. Mentes BB, Leventoglu S, Cihan A, Tatlicioglu E, Akin M, and Oguz M. Modified Limberg transposition flap for sacrococcygeal pilonidal sinus. Surg Today 2004. 34 (5):419-423.
6. Cihan A, Mentes BB, Tatlicioglu E, Ozmen S, Leventoglu S, and Ucan BH. Modified Limberg flap reconstruction compares favorably with primary repair for pilonidal sinus surgery. ANZ J Surg 2004. 74 (4):238-242.
7. Doll D, Matevossian E, Wietelmann K, Evers T, Kriner M, and Petersen S. The family history of pilonidal sinus predisposes to earlier onset of disease and a 50% long-term recurrence rate. Dis Colon Rectum 2009. 52 (9):1610-1615.
8. Arda IS, Guney LH, Sevmis S, and Hiçsonmez A. High body mass index as a possible risk factor for pilonidal sinus disease in adolescents. World J Surg 2005. 29 (4):469-471.
9. Hull TL and Wu J . Pilonidal disease. Surg Clin North Am 2002. 82 (6):1169-1185.
10. Cubukcu A, Gonullu NN, Paksoy M, Alponat A, Kuru M, and Özbay O. The role of obesity on the recurrence of pilonidal sinus disease in patients, who were treated by excision and Limberg flap transposition. Int J Colorectal Dis 2000. 15 (3):173-175.
11. Al-Khayat H, Al-Khayat H, Sadeq A, Groof A, Haider HH, Hayati H, et al. Risk factors for wound complication in pilonidal sinus procedures. J Am Coll Surg 2007. 205 (3):439-444.
12. Seyed Vahid Hosseini, Mohammad Rezazadehkermani, Reza Roshanravan, Khairallah Muzhir Gabash, Mahmoud Aghaie-Afshar. Pilonidal Disease: Review of Recent Literature. Ann Colorectal Res. 2014 June; 2(2): e19705.
13. Anna Drosou, Anna Falabella, Robert S. Kirsner. Antiseptics on Wounds: An Area of Controversy. Wounds. 2003;15(5)
14. Can MF, Sevinc MM, and Yilmaz M. Comparison of Karydakis flap reconstruction versus primary midline closure in sacrococcygeal pilonidal disease: results of 200 military service members. Surg Today 2009. 39 (7):580-586.
15. Osmanoglu G and Yetisir F . Limberg flap is better for the surgical treatment of pilonidal sinus: results of a 767 patients series with an, at least, five years follow-up period. Chirurgia (Bucur) 2011. 106 (4):491-494.
16. Anderson JH, Yip CO, Nagabhushan JS, and Connelly SJ. Day-Case Karydakis flap for pilonidal sinus. Dis Colon Rectum 2008. 51 (1):134-138.
17. Sondenaa K, Andersen E, Nesvik I , and Soreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 1995. 10 (1):39-42.
18. Sakr M, El-Hammadi H, Moussa M, Arafa S, and Rasheed M. The effect of obesity on the results of Karydakis technique for the management of chronic pilonidal sinus. Int J Colorectal Dis 2003. 18 (1):36-39.
19. Balik O, Balik AA, Polat KY, Aydinli B, Kantarci M, Aliagaoglu C, and Akcay MN. The importance of local subcutaneous fat thickness in pilonidal disease. Dis Colon Rectum 2006. 49 (11):1755-1757.
20. Mentes O, Bagci M, Bilgin T, Coskun I, Ozgul O, and Ozdemir M. Management of pilonidal sinus disease with oblique excision and primary closure: results of 493 patients. Dis Colon Rectum 2006. 49 (1):104-108.
21. Tekin A. A simple modification with the Limberg flap for the chronic pilonidal disease. Surgery. 2005;138(5):951-3. [DOI via Crossref] [Pubmed]
22. Conroy FJ, Kandamany N, Mahaffey PJ. Laser depilation and hy¬giene: preventing recurrent pilonidal sinus disease. J Plast Recon¬str Aesthet Surg. 2008;61(9):1069-72. [DOI via Crossref] [Pubmed]
23. Yeo MS, Shim TW, Cheong WK, Leong AP, Lee SJ. Simultaneous laser depilation and perforator-based fasciocutaneous Limberg flap for pilonidal sinus reconstruction. J Plast Reconstr Aesthet Surg. 2010;63(11):e798-800.
24. Oram Y, Kahraman F, Karincaoglu Y, Koyuncu E. Evaluation of 60 patients with pilonidal sinus treated with laser epilation after surgery. Dermatol Surg. 2010;36(1):88-91. [DOI via Crossref] [Pubmed]
25. Petersen S, Wietelmann K, Evers T, Huser N, Matevossian E, Doll D. Long-term effects of postoperative razor epilation in pilonidal sinus disease. Dis Colon Rectum. 2009;52(1):131-4. [DOI via Crossref] [Pubmed]
26. John Bascom, MD, Ph.D.; Thomas Bascom, MD. Failed Pilonidal Surgery New Paradigm and New Operation Leading to Cures. Arch Surg. 2002;137(10):1146-1150. [DOI via Crossref] [Pubmed]
27. Parlakgumus A, Ezer A, Caliskan K, Emeksiz S, Karakaya J, Co¬lakoglu T, et al. Effects of a tissue sealing-cutting device versus monopolar electrocautery on early pilonidal wound healing: a prospective randomized controlled trial. Dis Colon Rectum. 2011;54(9):1155-61. [DOI via Crossref] [Pubmed]
28. Duxbury MS, Blake SM, Dashfield A, Lambert AW. A randomized trial of knife versus diathermy in pilonidal disease. Ann R Coll Surg Engl. 2003;85(6):405-7. [DOI via Crossref] [Pubmed] [PMC Free Fulltext]
29. Abbasi HR, Hosseini SV, Yarmohammadi H, Bolandparvaz S. Com¬parison between two methods of excision and primary closure of pilonidal sinus. Iran Red Crescent Med J. 2007;9(3):143-6.
30. Yigit T, Yigitler C, Gulec B, Ihsan UA, Ozer T, Oner K. Do we need to use subcutaneous suture for pilonidal sinus treated with excision and simple primary closure? Acta Chir Belg. 2005;105(6):635-8.
31. Milone M, Di Minno MN, Musella M, Maietta P, Ambrosino P, Pisapia A, et al. The role of drainage after excision and primary closure of pilonidal sinus: a meta-analysis. Tech Coloproctol. 2013;17(6):625-30. [DOI via Crossref] [Pubmed]
32. Mavros MN, Mitsikostas PK, Alexiou VG, Peppas G, Falagas ME. Antimicrobials as an adjunct to pilonidal disease surgery: a systematic review of the literature. Eur J Clin Microbiol Infect Dis. 2013;32(7):851-8. [DOI via Crossref] [Pubmed]
33. Colov EP, Bertelsen CA. Short convalescence and minimal pain after out-patient Bascom's pit-pick operation. Dan Med Bull. 2011;58(12).
34. Zhou K, Krug K, Brogan MS.Management of a Dehisced Hand Wound Using Hydrogen Peroxide, Electrical Stimulation, Silver-containing Dressings, and Compression: A Case Study. Ostomy Wound Manage. 2015 Jul;61(7):32-7.
35. Lineaweaver W, Howard R, Soucy D, et al. Topical antimicrobial toxicity. Arch Surg. 1985 Mar. 120(3):267-70.
36. Leyden JJ, Bartelt NM. Comparison of topical antibiotic ointments, a wound protectant, and antiseptics for the treatment of human blister wounds contaminated with Staphylococcus aureus. J Fam Pract. 1987 Jun. 24(6):601-4.
37. Rodeheaver GT. Wound cleansing, wound irrigation, wound disinfection. Krasner D, Kane D. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals. 2nd. Wayne, PA: Health Management Publications, Inc; 1997. 97-108.
38. Plastic Surgery Practice. Fighting Wound Infection - Plastic Surgery Practice [Internet]. 2005 [cited 16 December 2015]. Available from: http://www.plasticsurgerypractice.com/2005/11/fighting-wound-infection/
39. Hyslop PA, Hinshaw DB, Scraufstatter IU, Cochrane CG, Kunz S, Vosbeck K. Hydrogen peroxide as a potent bacteriostatic antibiotic: implications for host defense. Free Radic Biol Med 1995; 19(1): 31-7. [DOI via Crossref]
40. Mangala B Murthy, Bhasker K Murthy, Sanjay Bhave. Comparison of safety and efficacy of papaya dressing with hydrogen peroxide solution on wound bed preparation in patients with wound gape. Indian J Pharmacol. 2012 Nov-Dec;44(6):784-7.

How to Cite this Article


Shirah, B. and Shirah, H. (2016) ‘The effect of hydrogen peroxide on the healing of the laid open wound in the treatment of chronic sacrococcygeal pilonidal sinus: A retrospective database analysis of 500 patients’, International Journal of Surgery and Medicine, 2(1), pp. 17–21. doi: 10.5455/ijsm.woundhealing.

Citations, Quotes & Annotations

Shirah, B. and Shirah, H. (2016) ‘The effect of hydrogen peroxide on the healing of the laid open wound in the treatment of chronic sacrococcygeal pilonidal sinus: A retrospective database analysis of 500 patients’, International Journal of Surgery and Medicine, 2(1), pp. 17–21. doi: 10.5455/ijsm.woundhealing.
(Shirah and Shirah, 2016)

Cited by:

1. Stauffer, V. K., et al. "Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence." Scientific reports 8.1 (2018): 3058.

2. Shirah, Bader Hamza, and Hamza Asaad Shirah. "Effect of surgical wound care methods of the lay open technique on the outcome of chronic sacrococcygeal pilonidal sinus management." Wound Medicine 16 (2017): 1-6.
3. Shirah, Bader Hamza, and Hamza Asaad Shirah. "Factors affecting the outcome and duration of healing of the laid open wound for sacrococcygeal pilonidal sinus: A prospective cohort study of 472 patients." Wound Medicine 18 (2017): 52-56.

Last modified onSunday, 03 June 2018 17:20