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Observational Study
. 2025 Jun 11;29(1):134.
doi: 10.1007/s10151-025-03159-7.

Prospective nationwide audit of short-term outcomes after surgery for chronic pilonidal sinus disease in the Netherlands

E A Huurman  1   2   3 , C A L de Raaff  4 , R van den Berg  4 , S J Baart  5 , B P L Wijnhoven  6 , R Schouten  7 , E J B Furnée  8 , B R Toorenvliet  9 , R M Smeenk  4 ; PITS collaborative study group
Collaborators, Affiliations
Observational Study

Prospective nationwide audit of short-term outcomes after surgery for chronic pilonidal sinus disease in the Netherlands

E A Huurman et al. Tech Coloproctol. .

Abstract

Background: The optimal surgical approach for chronic pilonidal sinus disease (PSD) remains unclear, resulting in variation in surgical practice. This study aimed to provide an overview of PSD subtypes and assess practice variation and short-term outcomes.

Methods: A nationwide prospective observational cohort study was conducted. All patients with PSD and who underwent surgery were included during a 3-month inclusion period between March 1, 2020 and March 1, 2021. Primary endpoints were PSD classification and type and frequency of surgical approach. Secondary endpoints included symptoms, complications, recurrent open wounds, wound healing rate, time to wound healing, time to resume daily activities, reasons for selecting therapy, antibiotic prophylaxis, type of anesthesia, and hospital admission.

Results: A total of 36 hospitals participated in the study, and 405 patients had chronic disease. The median follow-up period was 42 days. Mean age was 28 years and 335 (82.7%) patients were male. Simple (n = 213) and complex PSD (n = 192) was equally common. Twelve different treatment modalities were performed. Minimally invasive techniques were used the most (61.2%) and off-midline closure in only a small proportion of patients (5.7%). Minimally invasive techniques showed a significantly higher wound healing rate (41.1% vs 28.6%) and a shorter median time to closure (41 vs 78 days) compared to excision with secondary healing. They also had the shortest median time to resume daily activities (14 days).

Conclusions: Simple and complex PSD were equally common. Practice variation in surgery is substantial. Minimally invasive techniques were most frequently performed and showed good short-term outcomes.

Keywords: Excision with secondary healing; Minimally invasive techniques; Off-midline closure; Pilonidal sinus disease; Successful wound healing.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: The medical ethics committee of the University Medical Center Utrecht approved the study design (protocol number 20-671/C). Informed consent: Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Study population
Fig. 2
Fig. 2
Surgical treatments according to the classification system. ESW excision with secondary wound healing, MIT minimally invasive techniques, OMC excision with off-midline closure, EMC excision with midline closure
Fig. 3
Fig. 3
Surgical treatments by hospital. ESW excision with secondary wound healing, MIT minimally invasive techniques, OMC excision with off-midline closure, EMC excision with midline closure
Fig. 4
Fig. 4
Kaplan–Meier curve demonstrating the length of time to heal and number at risk table. ESW excision with secondary wound healing, MIT minimally invasive techniques
Fig. 5
Fig. 5
Kaplan–Meier curve demonstrating the length of time to resume daily activities and number at risk table. ESW excision with secondary wound healing, EMC excision with midline closure, OMC off-midline closure, MIT minimally invasive techniques
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References

    1. Yildiz T, Elmas B, Yucak A, Turgut HT, Ilce Z (2017) Risk factors for pilonidal sinus disease in teenagers. Indian J Pediatr 84(2):134–138 - PubMed
    1. Hueston JT (1953) The aetiology of pilonidal sinuses. Br J Surg 41(167):307–311 - PubMed
    1. Harlak A, Mentes O, Kilic S, Coskun K, Duman K, Yilmaz F (2010) Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors. Clinics (Sao Paulo) 65(2):125–131 - PMC - PubMed
    1. Doll D, Matevossian E, Wietelmann K, Evers T, Kriner M, Petersen S (2009) Family history of pilonidal sinus predisposes to earlier onset of disease and a 50% long-term recurrence rate. Dis Colon Rectum 52(9):1610–1615 - PubMed
    1. Brashear RI (1963) Observations on the etiology of pilonidal diseases. South Med J 56:727–729 - PubMed

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