Timeline of recurrence after primary and secondary pilonidal sinus surgery.
ABSTRACT This study was designed to evaluate the timeline of recurrence of pilonidal sinus disease after primary vs. multiple surgery. Data of medical military service in Germany were reviewed.
Telephone interview of 205 patients after pilonidal sinus disease surgery after median interval of 14.8 (standard deviation +/-3.9) years was conducted. A total of 345 patient charts with pilonidal sinus disease recurrence and fully documented previous surgery history were analyzed.
Pilonidal sinus disease recurred in 41 of 205 patients (20 percent; actuarial survival 22 percent) after first surgery. Median recurrence-free-interval was 1.8 (range, 0.1-16.5) years. Twenty-nine of 41 of all recurrences (71 percent) were observed within four years after primary surgery. Fifteen of 50 patients (30 percent) treated by primary closure had recurrent disease after a median recurrence-free interval of 2.7 (range, 0.2-13.5) years compared with 24 of 144 patients (17 percent), who experienced recurrence after rhomboid excision and open wound treatment after a median of 1.8 (range 0.1-16.5) years (P = 0.081, long-rank-test). Analysis of 345 recurrent disease charts revealed that recurrence time decreased for multiple recurrences compared with first recurrence (R1 vs. R2: P = 0.07; R2 vs. R3: P = 0.03, Mann-Whitney U test).
Long-term recurrence rate was 22 percent and thus higher than previously reported. This may be attributed to the long follow-up interval. Recurrences up to 20 years after surgery were seen. Our data provide evidence that follow-up after first to the third pilonidal sinus surgery should complete or exceed five years, because the majority of recurrences occur during this postoperative interval. Nevertheless, even a five-year follow-up will still miss 25 percent of recurrences.
- SourceAvailable from: Jorge Baixauli[Show abstract] [Hide abstract]
ABSTRACT: No definitive surgical treatment for non-acute pilonidal disease has been established thus far. We herein report the short-term and long-term outcomes of 74 consecutive patients who underwent the cleft lift procedure for non-acute pilonidal disease.Surgery Today 05/2014; · 0.96 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Pilonidal is a painful disease which occurs mainly in the sacrococcygeal area. In 1833 Herbert Mayo first reported a case of a young woman with a hair-containing sinus in the sacrococcygeal area. In 1880, Hodge suggested the term "pilonidal" from the Latin "pilus" for hair and "nidus" meaning nest. Effect of using autologous platelet-rich plasma (PRP) on pain reduction in patients with pilonidal abscess, subjected to extensive surgical removal tissue, was investigated through a clinical trial. The trial was conducted on two groups from the Center for Surgical Research at Mashhad University of Medical Sciences located at Ghaem hospital in Mashhad city in 2011. Purposive sampling was conducted and the samples were randomly assigned to two groups including test and control. All of the patients referred to the surgical unit of Imam-Reza hospital with acute pilonidal abscess (sacrococcygeal abscess) were considered and randomly assigned to two groups. Patients' dressing was not removed for two days. To avoid systematic errors (Bias), the resident who checked the wound for the first time was completely unaware of the patient's treatment plan. Recovery process and wound healing were monitored for the two groups and compared with each other (every other day for 10 days, and then once a week until complete healing). Data analysis was performed using SPSS19 software with Chi-square, independent t, and Mann-Whitney tests. Based on the obtained results it was found that the pain in the test group was significantly reduced in the first and fourth weeks (P < 0.05), compared to the control group. Therefore, it has been demonstrated that using PRP can significantly reduce pain in patients subjected to surgical treatment for their pilonidal abscess.Iranian Red Crescent medical journal. 11/2013; 15(11):e6301.
- [Show abstract] [Hide abstract]
ABSTRACT: Off-midline closure after excision and primary closure in the treatment of sacrococcygeal pilonidal disease has been suggested to improve surgical outcomes and reduce median recurrence rate. The aim of this study was to investigate several features known to be related to recurrence, allowing adequate comparison of recurrence between D-shaped asymmetric and symmetric excision in the treatment of sacrococcygeal pilonidal disease. An analysis of a prospectively maintained database of 569 surgical excisions performed for sacrococcygeal pilonidal disease between 1988 and 2007 was performed. The recurrence rate was lower in the asymmetric (n = 423) than in the symmetric (n = 101) group (9% vs 22.0%, P = .0001). After a median follow-up period of 11 years, 5-year 10-year, and 20-year disease-free survival rates were higher in the asymmetric group (94%, 92%, and 89% vs 84%, 79%, and 71%, respectively, P = .005). D-shaped asymmetric excision is an effective treatment of sacrococcygeal pilonidal sinus. Better long-term recurrence rates are achieved compared with symmetric excision, when stratified for several features known to be related to recurrence.American journal of surgery 10/2013; · 2.36 Impact Factor