Pilonidal Disease Management in Young Adults: A Retrospective Analysis of Practices in a single tertiary centre in Bahrain

Abstract

Abstract Background Pilonidal disease is a prevalent skin condition that predominantly affects young males. This study, conducted at Salmaniya Medical Complex in Bahrain, aimed to analyze the demographics, treatment methodologies, and complications associated with pilonidal disease. Materials and Methods We analyzed the medical records of 56 patients, comparing our practices to the American Society of Colon and Rectal Surgeons (ASCRS) guidelines. Variables collected included patient demographics (age and gender), details on preoperative and postoperative antibiotics, the type of surgical intervention performed, the closure technique used, and follow-up results at 2 months post-discharge, Results Our findings confirmed the high prevalence of the disease in young males (75%), with a median age at presentation being 20.5 years. Our practices showed minimal compliance (≤69%) to key recommendations. We found no documented practices for hair removal, phenol application, fibrin glue, or minimally invasive approaches. The most common surgical approach was primary closure (60%), followed by flap reconstruction (16%) and leaving wounds open (7%). The commonest complications were wound dehiscence and surgical site infection (27% each). Post-operative complications were significant, with 67.6% in patients who received pre- operative antibiotics and 63.6% in those who received post-operative antibiotics. However, no statistical link to closure type was found, likely due to our small sample size. Conclusion We recommend reassessing our management protocols to align with ASCRS guidelines and considering non-operative treatments to reduce morbidity. This study underscores the need for guideline adherence and the potential benefits of non-operative treatments in managing pilonidal disease.