Which surgical procedure offers the best treatment for pilonidal disease?

Abstract

Despite the increasing volume of data on the treatment of pilonidal disease, the optimal treatment has yet to be established.

Response to the Letter to the Editor on our article “Effective and minimally painful surgery of pilonidal sinus – asymmetric transposition plasty according to Dufourmentel” by Bechara et al.

“…For closed surgical procedures, no long follow‐up observation periods have yet been published in the literature. Published data show a recurrence rate of under 10% after 3–5 years of follow‐up [2–4]. The low recurrence rates (after up to 15 years of follow‐up) in our large patient collective can confirm these numbers.…”

Sinus pilonidalis in patients of German military hospitals: a review

“…A variety of risk factors for the recurrence of PSD were determined through the interview of select subgroups of patients fulfilling the respective study criteria. Risk factors for recurrence of PSD reported in the literature have been familiar disposition, obesity, female sex, number of sinuses, the cavity diameter and primary closure [ 40 ], [ 41 ], [ 42 ]. A weakness of our project were a lack of studies examining the risk factors of postoperative complications such as seromas, hematomas, wound-infections and dehiscences and their effect on long term recurrence rates.…”

Idea and innovation: Secure fixation between dermis and periosteum using perforator flap to prevent recurrence of pilonidal sinus disease

“…The common surgical managements are primary closure, lay open, local flaps, and perforator flap. These different procedures were compared, and despite the increasing volume of data on the treatment experience of PSD, optimal treatment has yet to be established as there is no 100% cure rate reported . Knowledge about perforator flap in the reconstruction of pilonidal sinus is limited.…”

“…These different procedures were compared, and despite the increasing volume of data on the treatment experience of PSD, optimal treatment has yet to be established as there is no 100% cure rate reported. 8 Knowledge about perforator flap in the reconstruction of pilonidal sinus is limited. Therefore, we aim to demonstrate a reliable surgical technique for wound closure of recurrent pilonidal sinus after radical excision using a superior gluteal artery perforator (SGAP) flap.…”