Abstract
BackgroundAlthough there are many therapeutic options to manage patients with sacrococcygeal pilonidal sinus disease, there remains controversy over a gold standard method for treating such patients. Most studies regarding sacrococcygeal pilonidal sinus, collected patients in a single pool, and single modality was performed to all patients so far. Staging according to the progressive nature of disease and comparisons of stage-based treatment approaches are yet to be conducted. This study aimed to define a staging system and to evaluate outcomes with the use of stage-based treatment approach.MethodsThe collected data of patients who underwent surgery for the treatment of pilonidal sinus disease prior to June 2011 were analyzed. Following this analysis, a staging system was defined based on morphological extent of disease (stage I to stage IV for primary disease, and stage R for recurrent disease). Specific surgical technique was used for each stage. Between June 2011 and December 2014, 367 patients were operated based on proposed staging system and treatment algorithm. Demographics, perioperative data, short-term and long-term outcomes were evaluated according to the disease stage.ResultsFor all patients, the median length of hospital stay was 1 (range, 0–4) day. Primary healing without any wound complications was achieved in 320 (87.2 %) patients. The median time to functional recovery was 10 (range, 2–35) days and for wound healing was 12 (range, 10–55) days. Disease recurrence was identified in six (1.6 %) patients within the median follow-up period of 29 (range, 5–47) months. The outcomes of each stage were evaluated separately.ConclusionsWe believe that the proposed staging system and stage-based treatment approach, which need further validation, will have an efficacy in the treatment of chronic pilonidal sinus disease and will contribute to the development of more appropriate individualized management approaches. Moreover, the use of this staging system will likely facilitate sharing and comparing more specific clinical data from future studies.Trial registrationNCT02712970 (ClinicalTrials.gov/09.03.2016)
Highlights
There are many therapeutic options to manage patients with sacrococcygeal pilonidal sinus disease, there remains controversy over a gold standard method for treating such patients
Despite the heterogeneous nature of the disease, in most of the previous studies, all patients were collected in a single pool and a single treatment protocol was performed to all patients without grouping the patients and without considering the extent of the disease severity
We aimed to propose a staging system in accordance with the progressive nature of pilonidal sinus disease
Summary
There are many therapeutic options to manage patients with sacrococcygeal pilonidal sinus disease, there remains controversy over a gold standard method for treating such patients. Sacrococcygeal pilonidal sinus disease (PSD) is a common condition that predominantly affects young adults [1] It is clinically asymptomatic in some cases, PSD may present as a chronic, complicated disease, characterized by multiple sinus tracts, leading to severe impairment of patient quality of life. Despite the heterogeneous nature of the disease, in most of the previous studies, all patients were collected in a single pool and a single treatment protocol was performed to all patients without grouping the patients and without considering the extent of the disease severity. Direct comparisons of stage-based treatment approaches are yet to be conducted
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
