Aspiration for acute pilonidal abscess-a cohort study

Area of Science:

• Surgical Procedures
• Infectious Diseases
• Patient Outcomes

Background:

• Traditional open incision and drainage for pilonidal abscesses result in prolonged healing and delayed return to daily activities.
• Pilonidal abscesses are common and can cause significant discomfort and disruption.
• Minimally invasive approaches are sought to improve patient recovery and satisfaction.

Purpose of the Study:

• To evaluate the safety and effectiveness of aspiration followed by antibiotics for treating acute pilonidal abscesses.
• To assess patient satisfaction levels with this minimally invasive treatment.
• To compare outcomes with traditional surgical drainage methods.

Main Methods:

• A prospective study involving 100 patients with acute pilonidal abscesses treated with bedside aspiration and a 7-day course of oral antibiotics (cefalexin and metronidazole).
• Exclusion criteria included immunosuppression, diabetes, skin necrosis, and perforation.
• Outcomes, including complications, long-term results, and patient satisfaction (using Visual Analogue Scales), were prospectively recorded.

Main Results:

• The study included 100 patients (50% female) with a median age of 24 years.
• Overall, 83% of patients were successfully treated with aspiration and antibiotics, with 7 patients requiring reaspiration.
• Only 10 patients needed subsequent incision and drainage; patient satisfaction was high, with a median Visual Analogue Scale score of 9/10.

Conclusions:

• Aspiration followed by antibiotics is an effective treatment for selected patients with pilonidal abscesses, achieving an 83% success rate.
• This approach is associated with high overall patient satisfaction.
• It offers a viable alternative to traditional incision and drainage, potentially reducing recovery time.