Abstract: Objective: To compare the efficacy of vacuum sealing drainage (VSD) combined with midline suture and primary midline suture in the treatment of sacrococcygeal pilonidal sinus. Methods: This study retrospectively analyzed the clinical data of 39 patients who were surgically treated for sacrococcygeal pilonidal sinus from January 2019 to January 2024 in Linyi People's Hospital, and were divided into 21 cases of VSD combined with midline suture (treatment group) and 18 cases of primary midline suture (control group) according to the surgical method. The differences between the two groups in terms of operative time, healing time, antibiotic usage rate, recurrence rate and local complication rate were compared. Results: TThe healing time, antibiotic usage rate, recurrence rate, and incidence of local complications in the treatment group were 13.95±1.60 days, 4.76%, 0%, 4.76%, respectively, while those in the control group were 24.11±3.77 days, 100%, 22.22%, and 27.78%, respectively. The operation time in the treatment group was longer than that in the control group (59.76±6.61 vs. 56.61±3.47 minutes), with statistically significant differences (Ps＜0.05). One case of wound dehiscence occurred in the treatment group; in the control group, there were 2 cases of wound dehiscence, 2 cases of skin edge necrosis, 1 case of infection, and 4 cases of recurrence. Conclusion: Compared with primary midline closure for sacrococcygeal pilonidal sinus, closed negative pressure drainage combined with midline closure has a longer operation time, but is associated with a lower recurrence rate, shorter healing time, fewer local complications, and a lower antibiotic usage rate.

Key words: sacrococcygeal pilonidal sinus, vacuum sealing drainage, primary midline suture