A Novel Scoring System for Pilonidal Disease: Predicting Complications and Guiding Surgical Management

Area of Science:

• Surgical innovation in managing chronic sacrococcygeal conditions.
• Development of predictive tools for patient stratification.

Background:

• Pilonidal disease is a chronic sacrococcygeal condition with high recurrence and complication rates.
• Lack of a standardized classification system hinders consistent treatment and prognosis prediction.

Purpose of the Study:

• To develop and validate the Hazem-Talaat score, a novel preoperative system for assessing pilonidal disease severity.
• To predict recurrence and guide surgical planning for pilonidal disease.

Main Methods:

• Prospective study of 156 patients (18-45 years) with primary or recurrent pilonidal disease.
• Incorporation of preoperative variables (BMI, sex, pits, diabetes, etc.) into the Hazem-Talaat score.
• Standardized surgical excision and off-midline closure, with a minimum six-month follow-up.

Main Results:

• Recurrence observed in 12.2% of patients; wound dehiscence in 16.7%.
• Recurrence significantly associated with male gender, higher BMI, diabetes, prior recurrence, and specific pit characteristics.
• Higher Hazem-Talaat scores correlated with increased recurrence risk (p < 0.001), with a cut-off of 21 identified.

Conclusions:

• The Hazem-Talaat score is an objective tool for predicting pilonidal disease recurrence and stratifying patients.
• Application of the score can improve surgical planning and patient outcomes.
• Further multicenter validation is recommended to confirm the score's utility.