Long-term results for pit-picking and flap procedures in primary pilonidal sinus disease

Area of Science:

• Surgical outcomes
• Pilonidal sinus disease management
• Minimally invasive surgery

Background:

• Pilonidal sinus disease (PSD) is a common inflammatory condition affecting young adults.
• Current treatment consensus for PSD is lacking, highlighting the need for evidence-based approaches.
• This study reports long-term outcomes of primary PSD surgical interventions.

Purpose of the Study:

• To compare the long-term efficacy and safety of two primary surgical techniques for pilonidal sinus disease (PSD).
• To evaluate outcomes of mini-invasive pit-picking surgery (PPS) versus asymmetrical excision with local flap (AELF).

Main Methods:

• Retrospective analysis of 146 patients undergoing primary PSD surgery (November 2010 - October 2015).
• Focus on 113 patients treated with either PPS (n=55) or AELF (n=58).
• Long-term follow-up data assessed recurrence rates and postoperative complications.

Main Results:

• PPS demonstrated higher day-surgery success (94.5% vs 32.8%), fewer complications (9.4% vs 36.2%), and shorter sick leave (14 vs 21 days).
• Initial healing rates were similar for both techniques (75.0% vs 76.8%).
• Long-term follow-up (median 9.3 years) revealed significantly higher recurrence rates for PPS (50.9%) compared to AELF (10.3%).

Conclusions:

• PPS is a viable option for primary PSD, particularly for simple sinus formations, despite its high recurrence rate.
• AELF is recommended for complex sinus formations due to its lower long-term recurrence.
• Patient selection and mastering diverse surgical techniques are essential for effective PSD management, warranting a classification system.