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Aspiration for acute pilonidal abscess-a cohort study.

Konstantinos Lasithiotakis1, Assad Aghahoseini1, Dimitra Volanaki1

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The Journal of Surgical Research
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Aspiration and antibiotics offer an effective treatment for pilonidal abscesses, leading to high patient satisfaction and quicker recovery compared to traditional methods.

Keywords:
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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.