Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 20:11:1456846.
doi: 10.3389/fsurg.2024.1456846. eCollection 2024.

Unroofing and curettage for recurrent sacrococcygeal pilonidal disease

Mehmet Ali Koc  1 , Haydar Celasin  2 , Kaan Sunter  1 , Cihangir Akyol  1 , Ibrahim Ethem Gecim  1
Affiliations

Unroofing and curettage for recurrent sacrococcygeal pilonidal disease

Mehmet Ali Koc et al. Front Surg. .

Abstract

Purpose: Sacrococcygeal pilonidal disease (SPD) is a global concern, notably in Southeast Europe and the Middle East. Unroofing curettage (UC), which provides faster recovery, better cosmetic appearance, and lower recurrence rates in the primary cases, was evaluated with the results of recurrent disease.

Methods: This retrospective study included 74 patients with recurrent disease who were over 16 years of age, experienced recurrence after at least one surgical attempt, and underwent unroofing curettage between 2007 and 2019. Operation time, return to work duration, and recurrence rates were assessed.

Results: Mean age of patients was 29.8 ± 10.6 years, and 61 (82.4%) were male. Previous procedures included excision + flap reconstruction, excision + primary closure, and local excision + lay open. Mean operation time for unroofing curettage was 22 ± 5.3 min. Mean durations for return to work and recovery were 5.9 ± 3 days, and 6.5 ± 2.6 weeks, respectively. Mean follow-up duration was 81.6 ± 49 months. Recurrence was only observed in 1 (1.3%) patient. Unroofing curettage showed a mean recurrence-free period of 156.9 months (95% CI [, 152.9-160.9 months).

Conclusion: Unroofing curettage stands out as a low-recurrence approach, likely to persist as a treatment method, especially for a selected group with recurrence.

Keywords: curettage; pilonidal cyst; pilonidal sinus; recurrence; sacrococcygeal pilonidal disease; unroofing.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Step-by-step description of the technique. (a) Wound after the patient is positioned and the surgical site is shaved. (b) The sinus tract is explored with a probe, and then unroofing is performed over the probe. (c) Hair can be seen in the opened wound. (d) The debris in the wound is removed by curettage. (e) Hemostasis is achieved. (f) Final wound.
Figure 2
Figure 2
Kaplan Maier analysis for the recurrence risk after unroofing curettage (UC) operation.
Figure 3
Figure 3
(a and b) Superficial recurrence, (c and d) Dehiscence of the wound.
Figure 4
Figure 4
(a and b) Recurrence after healing problem with the flap, (c and d) Recurrence underneath an otherwise healed flap.
See this image and copyright information in PMC

References

    1. Doll D, Orlik A, Maier K, Kauf P, Schmid M, Diekmann M, et al. Impact of geography and surgical approach on recurrence in global pilonidal sinus disease. Sci Rep. (2019) 9(1):15111. 10.1038/s41598-019-51159-z - DOI - PMC - PubMed
    1. Gecim IE, Goktug UU, Celasin H. Endoscopic pilonidal Sinus treatment combined with crystalized phenol application may prevent recurrence. Dis Colon Rectum. (2017) 60(4):405–7. 10.1097/DCR.0000000000000778 - DOI - PubMed
    1. Calikoglu I, Gulpinar K, Oztuna D, Elhan AH, Dogru O, Akyol C, et al. Phenol injection versus excision with open healing in pilonidal disease: a prospective randomized trial. Dis Colon Rectum. (2017) 60(2):161–9. 10.1097/DCR.0000000000000717 - DOI - PubMed
    1. Kuvvetli A, Çetinkunar S, Parlakgümüş A. Utility of methylene blue guided limberg flap on longterm recurrence in adult chronic pilonidal disease. Turkish J Color Dis. (2019) 29(3):118–20. 10.4274/tjcd.galenos.2019.93764 - DOI
    1. Garg P, Menon GR, Gupta V. Laying open (deroofing) and curettage of sinus as treatment of pilonidal disease: a systematic review and meta-analysis. ANZ J Surg. (2016) 86(1-2):27–33. 10.1111/ans.13377 - DOI - PubMed

LinkOut - more resources