Keywords

chronic wound, chronic nonhealing pilonidal sinus, dressing changes, pilonidal sinus, surfactant-containing polymer dressing, wound dressing

Authors

1. Sibbald, R. Gary MD, MEd, BSc, FRCPC (Med Derm), MACP, FAAD, MAPWCA
2. Persaud Jaimangal, Reneeka MD, MScCH
3. Coutts, Patricia M. RN
4. Elliott, James A. MSc

Abstract

GENERAL PURPOSE: To present an evaluation of a surfactant-containing polymeric membrane foam wound dressing for use on patients with chronic pilonidal sinus disease.

TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:

1. Recall risk factors for and pathophysiology of pilonidal sinus wounds.

2. Summarize the evidence-based elements of wound assessment and treatment.

3. Identify the study methodology and results.

ABSTRACT: OBJECTIVE:

To evaluate the clinical use of a surfactant-containing polymeric wound dressing with glycerin in patients with chronic pilonidal sinus wounds.

METHODS:

This case series was conducted in an outpatient dermatology and wound clinic. Sixteen patients aged between 18 and 49 years with chronic nonhealing pilonidal sinus wounds over 4 weeks in duration were recruited.

INTERVENTIONS:

Dressing changes were performed daily because of frequent contamination from bowel evacuation, sweating, or frictional forces in the perianal and intergluteal skin. Patients were seen at follow-up visits to the clinic at weeks 4, 8, and 12 from study initiation.

RESULTS:

Subjects were predominantly males (81% [n = 13]) with a mean age of 23 years. At study initiation, the mean wound duration was 3.2 months, and mean surface area was 3.3 cm² (0.18-19.6 cm²). The majority of wounds showed signs of superficial infection (63% [n = 10]) and deep infection (88% [n = 14]). At week 12, 10 wounds (63%) had closed, 1 (6%) had decreased in surface area, 2 (13%) had increased in size, and 3 (19%) of the patients were lost to follow-up. Mean pain score was 3.4 at first visit; most patients reported reduction in pain scores by weeks 4 and 12. Participants reported improved mobility and ability to self-apply dressing. No adverse reactions were observed.

CONCLUSIONS:

Use of a surfactant-containing polymeric membrane foam wound dressing with glycerin may have facilitated wound closure in 10 of 13 patients who completed the 12-week study.