Use of seton in chronic pilonidal sinus disease: a retrospective evaluation

Objective: To evaluate the efficacy, complication rates, recurrence, infection, and need for reoperation of the seton technique in the treatment of chronic pilonidal sinus disease. Methods: A retrospective review was conducted using our hospital’s general surgery database, analyzing patients treated with the seton technique for chronic pilonidal sinus between December 2018 and January 2020. Patients with incomplete records were contacted by phone for verification and included in the study. A total of 30 patients (6 female [20%], 24 male [80%]) were evaluated. The mean age was 26.4 ± 5.2 years (range: 18–39). Seton duration ranged from 16 to 24 weeks (mean: 20 weeks). In three patients (10%), wound closure was not achieved; these cases required skin incision, seton removal, and phenol injection support. Results: The technique was used in non-complicated cases (>2 cm size, <2 orifices) without a history of recurrence. This minimally invasive approach offered advantages such as low pain, no need for dressing or drainage, >90% cost reduction, and no hospital stay. Additional intervention was required in three cases (10%); the recurrence rate was 6.7%, and the infection rate was 3.3%. Conclusion: The seton technique is an effective, minimally invasive method for chronic pilonidal sinus disease, similar to fistula treatment principles. Phenol support is recommended to reduce long-term recurrence rates.