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In-Office Pit Excision for Pilonidal Disease Using Needle-Free Local Anesthesia: A Minimally Invasive, Non-Operative Treatment Approach.

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Improving Resource Utilization and Outcomes Using a Minimally Invasive Pilonidal Protocol.

Hajar R Delshad1, Owen Henry1, David P Mooney1

  • 1Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Journal of Pediatric Surgery
|November 3, 2019
PubMed
Summary
This summary is machine-generated.

A minimally invasive pilonidal protocol (MIPP) significantly reduced charges and improved healing rates in adolescents compared to surgical excision (SE). MIPP offers a more cost-effective and successful treatment for pediatric pilonidal disease.

Keywords:
Laser epilationPilonidalPit pickingQuality improvementResource utilizationSinusectomy

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Area of Science:

  • Surgical Innovation
  • Adolescent Health
  • Minimally Invasive Procedures

Background:

  • Pilonidal disease frequently affects adolescents, often requiring surgical intervention.
  • Traditional surgical excision (SE) can be associated with significant resource utilization and variable outcomes.
  • There is a need for more effective and less resource-intensive treatments for pediatric pilonidal disease.

Purpose of the Study:

  • To compare the resource utilization and clinical outcomes of a minimally invasive pilonidal protocol (MIPP) with standard surgical excision (SE) in adolescent patients.
  • To evaluate the cost-effectiveness of MIPP versus SE for treating pilonidal disease in a pediatric population.
  • To assess the healing and symptom resolution rates associated with MIPP compared to SE.

Main Methods:

  • A retrospective comparative study was conducted, analyzing data from 34 MIPP patients and 17 SE patients.
  • The MIPP involved improved hygiene, laser epilation (LE), and sinusectomy.
  • Key metrics analyzed included number of visits, LE treatments, care duration, operating room time, and healthcare charges.

Main Results:

  • MIPP patients underwent significantly fewer operating room minutes (258 vs. 2598) and lower average charges ($8440 vs. $29,098) compared to SE patients.
  • Healing or asymptomatic rates were substantially higher in the MIPP group (82%) versus the SE group (18%).
  • No significant differences were observed in the number of visits or overall care duration between the two treatment groups.

Conclusions:

  • The minimally invasive pilonidal protocol (MIPP) demonstrates superior clinical outcomes and significant cost reductions compared to traditional surgical excision (SE) in adolescents.
  • MIPP offers a more favorable risk-benefit profile for managing pediatric pilonidal disease.
  • These findings support the adoption of MIPP as a preferred treatment modality for adolescents with pilonidal disease.