[Surgical treatment of pilonidal disease]

Abstract

Background: Pilonidal disease is relatively common and is most often seen in young men. It presents either as acute abscesses or as chronic secretion of pus from inflamed sinus tracts in the gluteal region. Many different methods are used for surgical treatment and recurrences are common. We present an update for surgical treatment of pilonidal disease.

Material and methods: The article is based on literature identified through a non-systematic search in PubMed and the authors' clinical experience.

Results: An acute abscess has to be drained before curative surgery can be considered. Definitive surgery should be planned for continuous, recurrent or secreting pilonidal disease. A recent meta-analysis indicates that removal of an asymmetric skin flap and primary closure of the wound by mobilising skin from the opposite side (Bascom cleft-lift procedure) is associated with fewest recurrences, shortest time to healing and fewest infections.

Interpretation: The Bascom procedure should be the preferred surgical treatment for patients with pilonidal disease in a chronic phase.