Outpatient management of pilonidal disease

Abstract

Outpatient management of pilonidal disease is appropriate for abscesses and chronic sinuses. An abscess is drained but several options are available for treatment of a sinus. Our practice’s preference is unroofing with healing by secondary intention. Its advantages include immediate treatment, minimal pain, and a quick return to normal activities. Our experience with outpatient management of pilonidal disease is presented. From 1998 to 2002, 75 patients presented with pilonidal disease. Presentation, treatment, healing, and recurrences were reviewed. All were managed as outpatient. Abscesses were present in 34 and drained. Eighty-two percent healed and 12% developed a recurrence. All recurrences healed after undergoing unroofing. Chronic symptoms from a sinus were managed by incision/excision with secondary healing, primary closure, or a Bascom procedure. Unroofing was performed in 73%. Eighty-three percent healed and 24% developed a recurrence. Seventy-two percent of these healed for an overall rate of 77%. Pilonidal disease can be treated as an outpatient. An abscess should be drained. A chronic sinus can be managed with unroofing and healing by secondary intention, which allows patients to return to normal activities immediately after treatment.