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. 2019 May;23(5):435-443.
doi: 10.1007/s10151-019-01988-x. Epub 2019 May 16.

A systematic review of classification systems for pilonidal sinus

E M Beal  1   2 , M J Lee  3   4 , D Hind  5   4 , A P Wysocki  6   4 , F Yang  5 , S R Brown  3
Affiliations

A systematic review of classification systems for pilonidal sinus

E M Beal et al. Tech Coloproctol. 2019 May.

Abstract

Background: Pilonidal sinus disease (PSD) is a simple chronic inflammatory condition resulting from loose hairs forcibly inserted into vulnerable tissue in the natal cleft. It is an acquired disease with a slight familial tendency. There is no agreement on optimum treatment and the multitude of therapeutic options cannot be compared due to the lack of a universally adopted classification of the disease. The aim of our study was to perform a systematic review of the literature to determine how presentations of PSD are classified and reported.

Methods: A systematic review of the English language literature was undertaken searching studies published after 1980.

Results: Eight classification systems of PSD were identified. Most classification systems were based on anatomical pathology hypotheses. The location and number of sinuses were the main factors defining classification systems. No articles were retrieved that assessed the validity and/or reliability of the classification system employed. Furthermore, there was no evidence to suggest a correlation between prognosis outcome and subgroup.

Conclusions: Based on the evidence available from the literature reviewed we have no recommendations regarding the use of the current classification of PSD. A well-recognised and practical classification system to guide clinical practice is required.

Keywords: Classification system; Colorectal surgery; Pilonidal sinus disease.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Alluvial diagram of classification systems. *Definition for navicular area: When the buttocks are pushed together, the outer lines of contact represent the lateral edges of the natal cleft. Its inferior extent is the posterior border of the anal triangle, which has its tip at the apex of the coccyx and its base between the ischial tuberosities [17]
Fig. 3
Fig. 3
Classification systems: dimensions
See this image and copyright information in PMC

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