Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

Doll, Dietrich; Matevossian, Edouard; Luedi, Markus M.; Schneider, R.; Zypen, Dominic van der; Novotny, Alexander

doi:10.1159/000437361

Cited by 14 publications

(13 citation statements)

References 22 publications

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“…These procedures, which use different types of anaesthesia [ 2 ], are associated with advantages as well as disadvantages and may be associated with other cultural or geographical factors [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]. In any case, minimal intervention is recommended, as it is said to be associated with short theatre times, cost efficiency, and superior outcome [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease – A cohort of 327 consecutive patients

Doll

Petersen

Andreae

et al. 2022

Innovative Surgical Sciences

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Background Minimally invasive methods in pilonidal sinus disease (PSD) surgery are becoming standard. Although long-term results are available for some techniques, long-term outcome data of patients after pit picking is lacking. We aimed at investigating perioperative and long-term outcomes of patients undergoing pit picking, Limberg flap or primary open surgery to treat PSD. Methods In a single-centre observational study, we evaluated the outcomes of 327 consecutive patients undergoing PSD surgery between 2011 and 2020. Results PSD had recurred in 22% of Limberg flap patients and 62% of pit picking patients at 5 years (p=0.0078; log rank test). Previous pilonidal surgeries, smoking, body mass index, immunodeficiency, and diabetes did not significantly influence the long-term recurrence rate. Primary open treatment was performed for 72% of female patients presenting with primary disease. Conclusions Due to its especially dismal long-term results, pit picking should be abandoned, and Limberg flap should be promoted instead, even for primary disease and in females.

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Section: Introductionmentioning

confidence: 99%

Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease – A cohort of 327 consecutive patients

Doll

Petersen

Andreae

et al. 2022

Innovative Surgical Sciences

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“…In an analysis of a large cohort of PSD patients in the 1930s, the prevalence of women affected with PSD was around 20% 3 . An increasing number of studies reported during World War II noted a high prevalence of PSD in young male soldiers 4,5 . The military reported a lion's share of the disease burden, 6–8 and as mechanised warfare was new, the disease was referred to as ‘Jeep disease’ 4 .…”

Section: Introductionmentioning

confidence: 99%

“…The military reported a lion's share of the disease burden, 6–8 and as mechanised warfare was new, the disease was referred to as ‘Jeep disease’ 4 . During this time period, the number of women serving in the army was very limited 4,5 …”

Section: Introductionmentioning

confidence: 99%

Gender‐specific prevalence of pilonidal sinus disease over time: A systematic review and meta‐analysis

Luedi

Schober

Stauffer

et al. 2021

ANZ Journal of Surgery

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Background Gender‐specific risk factors have been suggested to promote a fourfold higher incidence of pilonidal sinus disease (PSD) in male as compared to female patients. However, in recent decades there has been an apparent shift towards an increasing prevalence of PSD in women, as body weight and other risk factors influence the disease. We aimed at determining whether PSD prevalence actually changed in men and women over time. Methods Following PRISMA guidelines (PROSPERO ID: 42016051588), databases were systematically searched. Papers reporting on PSD published between 1833 and 2018 in English, French, German, Italian and Spanish containing precise numbers of male and female participants were selected for analysis. Gender‐specific prevalence of PSD over several decades was the main outcome measure. Results We screened 679 studies reporting on 104 055 patients and found that the male/female ratio in patients with PSD has remained constant over time, with women being affected in about 20% of all PSD cases (I2 = 96.18%; meta‐regression p < 0.001). Conclusion While the prevalence of PSD has risen over the past decades, the ratio between affected males and affected females has remained constant, with women invariably representing about 20% of patients despite wide ranging socioeconomic and behavioural changes.

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“…Our study clearly demonstrates that relapse is more dependent on time than operative technique, which explains the variability in the relapse rates we can find in the literature, likely because it depends on the time elapsed from surgery in the study (3, 11). In a recent analysis on 583 young adults with a 20-year follow-up, Doll et al found a 44% relapse rate of primary midline closure (25). In addition, studies show that the great majority of relapses occurs within 5 years from surgery (3, 11), because of that we compared our MIT group with our benchmark represented by the EPC group with a median follow-up of 5 years.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

et al. 2019

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Background: Sacrococcygeal Pilonidal Disease (PD) is commonly treated with excision and primary closure techniques (EPC). Minimally invasive techniques (MIT), such as EPSiT and Pit-picking , had been recently advocated promising better outcomes. We analyzed mid-term results from our center after introduction of MIT to treat PD. Methods: Patients submitted to MIT ( n = 44) with a median follow-up of 37 months were analyzed and compared with patients submitted to EPC ( n = 70) with a median follow-up of 5 years. Both groups included patients operated in our department between 2011 and 2016 and have similar demographic and clinical characteristics. We compared operative time and post-operative parameters such as time with pain, dressing time and time to relapse. Results: The post-operative time with pain was significantly lower, whereas the dressing time was significantly longer, in MIT when compared to the EPC group. The relapse rate was similar in both groups but the follow-up is shorter in the MIT group. In addition, the analysis of patients free of disease using Kaplan-Meier curves revealed that relapse tends to occur more precociously in MIT than in EPC patients ( p = 0.014). Interestingly, in the subgroup of patients with previous surgery, MIT's relapse rate was significantly lower than in the EPC group (30 vs. 100%, p < 0.001). Conclusions: MIT has the advantage of having a shorter time with pain in the postoperative period, while EPC benefits from a shorter dressing time. In general, the relapse of the disease tends to manifest more precociously in MIT patients. Moreover, in the subgroup of patients with previous surgery, MIT seems to have significantly better results when compared to EPC.

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Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

Cited by 14 publications

References 22 publications

Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease – A cohort of 327 consecutive patients

Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease – A cohort of 327 consecutive patients

Gender‐specific prevalence of pilonidal sinus disease over time: A systematic review and meta‐analysis

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

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