Rethinking the causes of pilonidal sinus disease: a matched cohort study

Doll, Dietrich; Brengelmann, Imke; Schober, Patrick; Ommer, A.; Bosche, Friederike; Papalois, Αpostolos; Petersen, Sven; Wilhelm, Dirk; Jongen, Johannes; Luedi, Markus M.

doi:10.1038/s41598-021-85830-1

Cited by 24 publications

(20 citation statements)

References 27 publications

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“…First, an increased level of health awareness in both sexes might have led to a higher number of women reportedly seeking surgical therapy for PSD 26 . While women's and men's lifestyles might become more similar, no lifestyle related factors have indicated an increase in PSD prevalence over the short or long term 27,33,34 . Yet, data from early studies might be biased by the fact that the incidence of the disease is not growing over time but rather women are able to access care and be diagnosed/ treated with greater frequency in the modern era 26 .…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…The discrepancies in reported results may be a result of factors such as regional differences, 25 study design or selection bias 26,27 . Therefore, we designed a systematic review and meta‐analysis to determine whether there has been a shift in the prevalence of PSD reported in men and women since 1833.…”

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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“…Among them are minimally invasive surgery (such as the so-called “pit picking”) [ 1 ], excisional procedures using a lay-open technique, primary closure, and off-midline plastic reconstructive operations. 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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“…Although the etiology of the disease is not fully understood, the main known risk factors include obesity (BMI> 25kg/m 2 ), prolonged sitting, deep birth clefts in the navicular region, local trauma, hormonal disorders, poor hygienic behavior, hairy body type and smoking (9)(10)(11). When evaluated in terms of BMI, no statistically significant difference was found between the treatment methods in the study.…”

Section: Discussionmentioning

confidence: 78%

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

Çantay

Daşdemir²

2021

Journal of Basic and Clinical Health Sciences

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Purpose: Although many conservative and surgical methods have been described in the treatment of sacrococcygeal pilonidal sinus, which is a common disease of the sacrococcygeal region, affecting especially young men, recurrence rates are still high and the search for ideal treatment continues. The aim of the study is to compare the primary closure, Limberg and Karydakis flap methods for pilonidal sinus surgery in terms of wound healing, complications and recurrence and to present the results accordingly. Methods:The data of 184 patients who were operated between 2018 and 2020 were retrospectively evaluated. Patient data on age, gender, comorbidity, Body Mass Index (BMI), smoking, recurrence, history of preoperative abscess drainage, surgical methods, length of hospital stay, postoperative drain, recurrence and complications were evaluated. Results:No statistically significant difference was found between the treatment methods in terms of age, gender, Body Mass Index, and smoking (p>0.005). A statistically significant difference was found between the treatment methods in terms of reoperation for recurrence and preoperative abscess drainage (p = 0.012) (p = 0.044). However, a significant difference was found between the treatment methods in terms of length of hospital stay, presence of drainage, recurrence and complications (p <0.005). Conclusion:Although primary suturation has a short hospital stay, the rate of recurrence and complications is higher than the Limberg and Karydakis flap methods. In this context, it can be maintained that the Limberg and Karydakis flap methods are safer methods than the primary closure method.

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Rethinking the causes of pilonidal sinus disease: a matched cohort study

Cited by 24 publications

References 27 publications

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

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

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

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

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