Chronic pilonidal disease: a randomized trial with a complete 3-year follow-up

Area of Science:

• Surgical innovation
• Clinical trial methodology
• Dermatologic surgery

Background:

• Chronic pilonidal disease presents a significant clinical challenge.
• Existing surgical treatments for pilonidal disease have variable outcomes.
• Minimizing recurrence and healing time are key goals in pilonidal disease management.

Purpose of the Study:

• To compare the efficacy of three surgical treatments for chronic pilonidal disease.
• To evaluate healing rates, healing times, and recurrence rates.
• To determine the optimal surgical approach for pilonidal disease management.

Main Methods:

• A randomized controlled trial was conducted.
• Participants received one of three treatments: excision (E), excision with suture (E + S), or excision with suture under clindamycin cover (E + S + C).
• Outcomes including healing, healing time, and recurrence within 3 years were assessed.

Main Results:

• Healing rates without new sinus formation were comparable across all three treatment groups (E, E + S, E + S + C).
• Healing time was significantly shorter for E + S (14 days) and E + S + C (11 days) compared to E (64 days).
• Recurrence rates within 3 years were 13% (E), 25% (E + S), and 19% (E + S + C).

Conclusions:

• Excision with suture (E + S) and antibiotic cover (E + S + C) offer faster healing for chronic pilonidal disease than simple excision (E).
• While recurrence rates varied, the overall treatment time, including recurrences, was shorter with E + S and E + S + C.
• Surgical techniques involving sutures and antibiotic cover show promise in improving outcomes for pilonidal disease treatment.