In this procedure, the surgeon does a wide-bore local excision of the skin containing the sinus tract. The resulting cavity is left open to heal and fill in naturally from the bottom upwards. The wound is kept covered with a dressing. The disadvantage of wide excision is that the wound size is large and healing may take up to 3 months. The dressing needs to be changed daily making it a tedious process. However, the procedure is safe with a recurrence rate of 10-15%. In this procedure, the abscess and sinus are surgically removed and the wound is closed with stitches/sutures. The stitch line is preferably off the midline, where the tension is less and chances of healing are better. The advantage of this technique is that the healing is faster and takes about 4-6 weeks. The main drawback is that the infection rate is almost 20-25%. In case of such an infection, a revision procedure is done and the wound is left for open healing anyway.
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