Comparison of Simple Drainage Versus Drainage With Tract Destruction in the Management of Pilonidal Abscess

Pilonidal disease is an acquired condition primarily affecting the gluteal cleft and sacrococcygeal area, often complicated by the formation of sinuses and abscesses. Despite multiple surgical options, there is no universally accepted standard treatment. This study aimed to compare the outcomes of simple drainage alone versus drainage combined with sinus destruction using the same incision technique.

Between February 2019 and March 2024, a total of 480 patients with acute pilonidal abscesses received treatment. Of these, 235 underwent simple drainage (Group A), while 245 had drainage with sinus damage (Group B). All participants were followed for at least nine months, with recurrence rates recorded throughout. Statistical analysis was performed using SPSS version 28 (IBM Corp., Armonk, NY, USA).

In Group A, 131 patients (55.7%) experienced a recurrence, compared to only 29 patients (11.8%) in Group B. This difference is statistically significant (p < 0.001). The majority of recurrences occurred in younger, male, and overweight individuals.

Removing the sinus tract during the same procedure as abscess drainage greatly lowers the chance of the abscess recurring, compared to drainage alone. Incorporating sinus destruction into the initial surgery might eliminate the need for subsequent operations for people with pilonidal abscesses.