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Pilonidal Sinus Management; Bascom Flap Versus Pilonidal Pits Excision: A Single-Center Experience.

Ashraf Imam1, Harbi Khalayleh1, Guy Pines1

  • 1Department of General Surgery, Kaplan Medical Center, Rehovot; Hebrew University School of Medicine, Jerusalem, Israel.

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Summary

The Gips procedure is recommended for simple pilonidal disease, while the Bascom cleft lift (flap) is effective for recurrent cases, showing good success and quick healing. This challenges traditional wide excision methods.

Keywords:
AbscessDrainageMinimally invasive surgical proceduresPilonidal sinusSurgical flaps

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Area of Science:

  • Surgical Outcomes
  • Pilonidal Sinus Disease Management

Background:

  • Pilonidal sinus disease affects young adults, often requiring surgical intervention.
  • Recurrent cases pose treatment challenges, with varying success rates for different surgical techniques.

Purpose of the Study:

  • To compare the outcomes of the Bascom cleft lift (flap) and Gips procedure for pilonidal sinus excision.
  • To evaluate complication and recurrence rates for both surgical methods.

Main Methods:

  • Retrospective review of 53 patients undergoing pilonidal sinus excision between November 2013 and August 2017.
  • Inclusion criteria: Bascom cleft lift or Gips procedure.
  • Data collected: perioperative complications and recurrence rates.

Main Results:

  • The Gips procedure is recommended for simple pilonidal disease.
  • The Bascom cleft lift (flap) showed a higher rate of minor wound dehiscence (40%) but excellent success for recurrent disease.
  • Pits picking after wide local excision had an 80% recurrence rate compared to 0% for other methods.

Conclusions:

  • The Gips procedure is the preferred treatment for simple pilonidal disease.
  • The Bascom cleft lift (flap) is a viable option for recurrent pilonidal disease, offering good success and rapid healing.
  • Findings question the widespread use of traditional wide excision techniques.