Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Area of Science:

• Surgical outcomes
• Recurrence patterns
• Pilonidal sinus disease management

Background:

• Pilonidal sinus disease (PSD) frequently affects young men, leading to significant social and work life disruption.
• Recurrence of PSD (rPSD) poses challenges, prompting investigation into optimal reoperation strategies.
• Understanding predisposing factors for rPSD is crucial for improving surgical outcomes.

Purpose of the Study:

• To analyze patients with recurrent pilonidal sinus to identify predisposing features for recurrence.
• To evaluate the outcomes of surgical methods used for recurrent pilonidal sinus disease.
• To determine if changing surgical strategy after recurrence impacts further relapses.

Main Methods:

• Retrospective analysis of 62 recurrent pilonidal sinus disease (rPSD) patients operated between 2007 and 2012.
• Data collected included demographics, previous and current operation types, patient satisfaction, and pain scores.
• Statistical analysis included Student's t test, Mann-Whitney U test, and Kaplan Meier for disease-free survival.

Main Results:

• The study included 62 rPSD patients with a male:female ratio of 2.9:1.
• One and five-year recurrence rates were 33.9% and 66.1%, respectively.
• Flap reconstruction groups reported better pain perception and satisfaction scores compared to other methods.

Conclusions:

• Reoperative surgery for rPSD can be satisfactory with appropriate precautions.
• Relapses after flap reconstruction may represent a second primary disease, distinct from simple recurrence.
• Changing surgical strategy is not always necessary; re-flap surgery is well-regarded after any relapse.