Recurrence of Pilonidal Disease: Our Best is Not Good Enough

Area of Science:

• Pediatric Surgery
• Wound Healing
• Chronic Disease Management

Background:

• Pilonidal disease recurrence rates can reach 30%, leading to chronic wounds, disability, and reduced quality of life.
• Recurrent pilonidal disease presents significant long-term challenges for patients.

Purpose of the Study:

• To characterize recurrence rates of pilonidal disease in patients treated by pediatric surgeons.
• To identify factors associated with pilonidal disease recurrence.

Main Methods:

• A single-center retrospective review of 307 patients treated for pilonidal disease between 2010 and 2015.
• Recurrence was defined as active disease requiring intervention >30 days post-treatment.
• Repeated events proportional hazards regression modeling was used to analyze time to recurrence.

Main Results:

• The overall recurrence rate was 33%, with 80% of recurrences occurring within the first year.
• Obesity (BMI ≥ 95th percentile) was the only factor independently associated with time to disease recurrence.
• Initial treatments included surgical excision (two-thirds) and incision/drainage and/or antibiotics (one-third).

Conclusions:

• Pilonidal disease demonstrates a substantial recurrence rate, even after surgical intervention.
• Further research is necessary to develop treatments that can effectively prevent pilonidal disease recurrence.