Aetiology, presentation and management of pilonidal disease

Abstract

Pilonidal disease is a common benign condition usually treated by coloproctologists. Its aetiology has been debated, but the evidence points to an acquired, rather than congenital mechanism. Symptom severity is variable, as are surgical approaches to management, with a lack of good quality evidence in the literature. The optimal surgical treatment of pilonidal disease remains controversial. Recurrence and unhealed midline wounds are the main problems following surgery. In general, those surgical procedures that result in wounds away from the midline (natal cleft) are considered to be more successful. Strict attention to nursing care of postoperative wounds is crucial to outcome.