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Related Experiment Video

Updated: Jan 28, 2026

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
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The Management of Pilonidal Sinus.

Igors Iesalnieks1, Andreas Ommer

  • 1München Klinik Bogenhausen; Center of Coloproctology Essen.

Deutsches Arzteblatt International
|February 21, 2019
PubMed
Summary

Minimally invasive treatments for pilonidal disease offer faster recovery but have higher recurrence rates. Off-midline excisional techniques are preferred for complex cases, while midline excision and shaving are not recommended.

Area of Science:

  • Medical science
  • Surgical innovation
  • Clinical evidence

Background:

  • Pilonidal disease is a common subcutaneous infection, primarily affecting the natal cleft.
  • In Germany, the incidence was 48 cases per 100,000 persons annually in 2012.

Purpose of the Study:

  • To review current minimally invasive and excisional techniques for pilonidal disease treatment.
  • To evaluate recurrence rates, wound healing duration, and suitability for different patient groups.

Main Methods:

  • Selective literature search of pertinent publications.
  • Analysis of evidence levels (LoE) from systematic meta-analyses and trials.

Main Results:

  • Minimally invasive techniques are atraumatic, allowing near-immediate return to work, but have higher recurrence rates (LoE: Ib).

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  • Off-midline excisional techniques show shorter wound healing times and are recommended for re-operated or large lesions (LoE: Ia).
  • Midline excision with primary closure and postoperative shaving are not advised (LoE: Ia, IV).

    • Conclusions:

    • Further randomized trials are necessary to establish the efficacy of newer minimally invasive techniques.
    • Off-midline excisional approaches appear superior for specific patient populations based on current evidence.