Abstract: Impact of polymeric membrane silver rope cavity filler on the management of difficult to close pilonidal sinuses (2016 WOCN Society & CAET Joint Conference)

R. Gary Sibbald, Bsc, MD, FRCPC, (Med, Derm), MACP, FAAD, MEd, FAPWCA, University of Toronto, Professor of Public Health Sciences and Medicine, University of Toronto, Toronto, ON, Canada, Patricia Coutts, RN, Wound healing Center, Toronto Regional (Dermatology) & Wound Healing Clinic, Toronto, ON, Canada, James Elliott, MSc, BSc, Toronto Regional (Dermatology) & Wound Healing Clinic, Mississauga, ON, Canada and Reneeka Persaud, MD, IIWCC Canada, Toronto Regional Wound Healing Clinic/University of Toronto, Mississauga, ON, Canada

Background and Aims

Pilonidal sinus is a cyst or abscess near or on the natal cleft of the buttocks.¹This study examined patients with stalled and difficult to close pilonidal sinuses in a clinic based in Mississauga, Canada. The study aimed to assess the impact of polymeric membrane silver rope cavity filler, used with debridement, hair removal, and systemic antibiotics. The polymeric membrane silver rope cavity filler wound dressing is designed for use in tunnels, where it has been designed to facilitate an inflammatory response into the primary site of injury and reduce the spread of swelling into the surrounding tissues.^2,3

Methods

Polymeric membrane silver rope cavity filler was inserted into the sinuses. Secondary dressings included dry gauze, silicone tape and sanitary napkin/pad.

Results

In total 16 patients (13 male, 3 female) presented with an open wound at their initial visit. Of these 94% (n=15) had at least 1 prior surgical intervention. At initial assessment average patient age was 23 (16-49). Mean pain score was 3.4 (0-10 scale); 94% (n=15) of wounds were classified as healable and 6% (n=1) were maintenance. Mean wound surface area was 3.3 cm² (range: 0.2-19.6 cm²). Based on NERDS criteria, 63% (n=10) were critically colonized.⁴ Based on STONEES criteria, 88% (n=14) met criteria for deep infection.⁴At the second visit, 37% (n=6) of the pilonidal sinus wounds were closed. By the final visit 68% (n=11) were closed. Longest evaluation period was 6 visits. An additional 12% (n=2) were smaller at the final visit, along with 12% (n=2) that were larger in size; one case (6%) had no follow up visit.

Conclusions:

Use of polymeric membrane silver rope cavity filler, combined with expert clinic diagnosis and comprehensive treatment, lead to successful wound healing outcomes in 80% of patients with stalled and difficult to close pilonidal sinuses.

RS16-040 Impact of polymeric membrane silver rope cavity filler on the management of difficult to close pilonidal sinuses