Abstract
Surgery for pilonidal disease carries a considerable risk of complications, recurrence, and cosmetic sequelae. The present study evaluates the four procedures performed in our institution. Operations from 1999 through 2002 were retrospectively assessed. Cosmetic result and overall satisfaction were reported on visual analogue scales. Seventy-three procedures were performed in 71 patients: excision with open granulation in nine; excision and primary suture in 25; rhomboid plasty in 23; and lay-open in 16 patients. Infections were as frequent after rhomboid plasty (40%) as after excision and primary suture (43%). Nineteen recurrences (26%) were observed during a median follow-up of 20 months, and the estimated five-year actuarial recurrence rate was 44%. Recurrence occurred in 1/9 (11%) after excision with granulation, in 4/23 (17%) after excision and suture, in 5/25 (20%) after rhomboid plasty, and in 9/16 patients (56%) after lay-open. The cosmetic result was satisfactory only in 22/53 (42%) patients; the result was poor in 16/53 (30%) patients. Results after surgery for pilonidal disease are modest and should be compared to conservative management in a randomised trial.
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