Search Our Scientific Publications & Authors

Cutis 2018 Oct;102(4):E23-E29

Department of Dermatology, State University of New York Downstate, and Department of Dermatology, Brooklyn Campus of the VA NY Harbor Healthcare System, Brooklyn, New York, USA.

Pilonidal sinus disease often presents as a chronic problem in otherwise healthy hirsute men. A range of conservative techniques to surgical flaps have been employed to treat this condition. We review the literature on management of pilonidal sinus disease, including conservative and surgical techniques as well as novel laser therapy. Read More

J Surg Res 2018 Dec 21;232:430-436. Epub 2018 Jul 21.

Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio. Electronic address:

Background: Recurrence rates of pilonidal disease have been reported to be high as 30%. Patients with recurrent pilonidal disease often develop chronic wounds and draining sinuses that incur long-term morbidity, disability, and decreased quality of life. The aim of this study was to characterize rates of recurrence in patients with pilonidal disease treated by pediatric surgeons. Read More

Int Wound J 2018 Nov 15. Epub 2018 Nov 15.

Wound Healing Research Unit, Cardiff University, Cardiff, UK.

The ideal treatment for patients who suffer from pilonidal sinus disease should lead to a cure with a rapid recovery period allowing a return to normal daily activities, with a low level of associated morbidity. A variety of different surgical techniques have been described for the primary treatment of pilonidal sinus disease and current practice remains variable and contentious. Whilst some management options have improved outcomes for some patients, the complications of surgery, particularly related to wound healing, often remain worse than the primary disease. Read More

Prague Med Rep 2018 ;119(2-3):107-112

Grantham and District Hospital, Grantham, United Kingdom.

The aim of this study was to compare the filling of the pilonidal sinus tract with fibrin sealant (FS) against tract excision and primary closure (PC) as the primary procedure. Details of all patients who underwent treatment for a symptomatic first episode of pilonidal sinus disease between January 2011 and December 2015 were prospectively recorded in a custom database. Patients underwent PC (n=17) or FS (n=17) according to patient preference. Read More

Tech Coloproctol 2018 Oct 9;22(10):779-784. Epub 2018 Nov 9.

Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.

Background: Pilonidal sinus disease (PSD) is a common, chronic inflammatory condition involving hair follicles within the natal cleft. It mainly affects young males and creates a significant health, social and economic burden. Traditional surgery is often radical resulting in pain, wound complications, long recovery times and poor cosmesis. Read More

Dis Colon Rectum 2018 Dec;61(12):e376

Garg Fistula Research Institute, Panchkula, Haryana, India.

Trials 2018 Nov 1;19(1):599. Epub 2018 Nov 1.

Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, FB 3A.3, Columbus, OH, 43205, USA.

Background: Laser hair depilation is a promising therapy in the management of pilonidal disease. However, the large controlled trials needed to demonstrate the effectiveness of this practice have not been performed.

Methods: We designed a single-center randomized controlled trial that will enroll 272 patients with pilonidal disease. Read More

Dermatology 2019 26;235(1):45-50. Epub 2018 Oct 26.

Dermatology Department, Hospital Universitario San Cecilio, Granada, Spain.

Background/aims: Hidradenitis suppurativa (HS) is a chronic inflammatory and destructive skin disorder. Early diagnosis and treatment are critical to stop its progression. Data concerning adolescent-onset HS are scarce. Read More

Pan Afr Med J 2018 28;30:60. Epub 2018 May 28.

Dermatology Division, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

[This corrects the article DOI: 10.11604/pamj.2018. Read More

Tech Coloproctol 2018 Oct 10;22(10):773-778. Epub 2018 Oct 10.

Iasi Private Medical Center, 75 Dodonis avenue, 45221, Ioannina, Greece.

Background: The aim of the present study was to assess the effectiveness of the minimally invasive technique pilonidal disease laser treatment (PiLaT) in treating primary (non-recurrent) pilonidal disease in an outpatient setting under local anaesthesia.

Methods: A prospective observational study was conducted on consecutive patients suffering from primary pilonidal disease that were treated at Iasi Private Medical Center, Ioannina, Greece, between April 2015 and December 2016, using a 1.470 nm diode laser (BioLitec, Germany) emitting energy through a radial optic fiber that was inserted in the cyst and accompanying sinus tracts. Read More

Ann R Coll Surg Engl 2018 Oct 5:1-9. Epub 2018 Oct 5.

Colorectal Surgery Unit, General Surgery Department, Faculty of Medicine, Mansoura University Hospitals , Mansoura City , Egypt.

Background: Although several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.

Methods: This was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). Read More

J Pediatr Surg 2018 Sep 8. Epub 2018 Sep 8.

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE2.

Background / Purpose: Sacrococcygeal pilonidal sinus disease (PSD) has an incidence of 1.2-2.5/1000 in children. Read More

Turk J Surg 2018 Sep 13:1-6. Epub 2018 Sep 13.

Department of Psychiatry, Edremit State Hospital, Ankara, Turkey.

Objectives: The aim of the present study was to evaluate the subjective sleep quality in patients with anorectal disorder, to determine the factors associated with subjective sleep quality, and to explore the relationship between subjective sleep quality and quality of life.

Material And Methods: This descriptive study was conducted between April 8, 2015 and April 12, 2016. The research population consisted of 284 patients who attended the general surgery outpatient clinics of Konya Military Hospital and were subsequently diagnosed with one of the four most common anorectal disorders (hemorrhoidal disease, anal fissure, anorectal abscess/fistula, and sacrococcygeal pilonidal disease). Read More

Int Wound J 2018 Sep 21. Epub 2018 Sep 21.

Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.

In the past decades, numerous surgical techniques and conservative treatments for pilonidal sinus disease (PSD) had been discussed and published. There is still no consensus yet of the best techniques because of high recurrence rates and prolonged wound healing. In the case of complicated discharging sinus or recurrent PSD resistant to treatment with antibiotics, we recommend radical excision followed by a regional flap, which can obliterate the dead space with well-vascularised tissue. Read More

ANZ J Surg 2018 Sep 21. Epub 2018 Sep 21.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Background: Karydakis published a large pilonidal series in 1992, reporting a recurrence rate of less than 1% and complication rate of 8.5%. The aim of this study was to compare the outcomes of Karydakis procedure (KP) performed in the lateral versus the prone position in a consecutive series. Read More

Colorectal Dis 2018 Nov 1;20(11):1047. Epub 2018 Oct 1.

Indus Super Specialty Hospital, Mohali, India.

Turk J Surg 2018 Aug 28:1-5. Epub 2018 Aug 28.

Department of General Surgery, Kanuni Training and Research Hospital, Trabzon, Turkey.

Objectives: Although many surgical techniques have been described for treatment of pilonidal sinus disease (PSD), the ideal treatment method remains controversial. The purpose of this study was to compare Limberg flap and oval flap techniques in patients with PSD.

Material And Methods: Patients diagnosed with PSD who underwent surgery using either the Limberg flap or oval flap technique between January 2012 and January 2016 at the general surgery outpatient clinic were retrospectively reviewed from the database of our hospital; 142 patients (124 males and 18 females) were invited for examination. Read More

Acta Chir Belg 2018 Dec 12;118(6):398-401. Epub 2018 Sep 12.

b Department of Abdominal Surgery , University Hospital of Antwerp , Edegem , Belgium.

Background: Fistula formation in hidradenitis suppurativa follows an uncontrolled infection with subcutaneous tracts leading to 'watering-can' or 'pus-pot' perineum. Closure of this type of fistula implies major surgery and is bound to fail in refractory inflammatory environment. Minimally invasive techniques have become the first line of choice in every type of surgery. Read More

Surgeon 2018 Aug 22. Epub 2018 Aug 22.

Department of Colorectal Surgery, Beaumont University Hospital, Dublin, Ireland.

Introduction: Pilonidal disease (PD) is associated with significant disability culminating in time off work/school. Recurrence rates remain high following conventional surgical interventions. Flap-based techniques are postulated to decrease recurrence. Read More

Cureus 2018 Jun 14;10(6):e2806. Epub 2018 Jun 14.

Surgery, Al Noor Surgery Hospital, Chakwal, PAK.

Introduction Pilonidal disease is a common disease mostly affecting young males with a significant reduction in their working capabilities, hence, ideal and simple management of this disease is very important. Our study objective was to assess the recurrence rate of pilonidal sinus disease in patients with a complete excision of the pilonidal sinus, its track, and the sudoriferous gland area en-bloc with primary repair. Methods This descriptive study was conducted at Al-Noor Surgery, Chakwal, Pakistan, from February 2015 to July 2017. Read More

J Plast Reconstr Aesthet Surg 2018 Nov 8;71(11):1631-1636. Epub 2018 Jun 8.

St Helens & Knowsley NHS trust, UK. Electronic address:

Aim: To assess the efficacy of the lotus petal flap in difficult pilonidal sinus management.

Background: Pilonidal sinuses may be difficult to treat. Five year recurrence rates range from 18% to 50% Recurrence rates fall with primary closure rather than healing by secondary intention. Read More

Surg Infect (Larchmt) 2018 Aug/Sep;19(6):566-572. Epub 2018 Aug 10.

1 Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.

Background: Laser hair depilation has shown promise in small series of patients with pilonidal sinus disease. The purpose of this study was to review the published literature on laser hair depilation in pilonidal disease to determine its effect on disease recurrence.

Methods: The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched to identify all studies published through December 1, 2017 that examined the role of laser hair depilation in the treatment of pilonidal sinus disease. Read More

Ann Plast Surg 2018 Dec;81(6):e12-e19

From the USC Division of Plastic and Reconstructive Surgery, Los Angeles, CA.

Background: Pilonidal disease (PD) is a recalcitrant condition associated with significant morbidity. It affects 26 in 100,000 individuals; however, there is no consensus on optimal surgical treatment, and up to half of patients struggle with recurrence. This review appraises the current literature on techniques and outcomes of PD surgery, to better guide decision making. Read More

Eur Rev Med Pharmacol Sci 2018 Aug;22(15):4755-4756

Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy.

Langenbecks Arch Surg 2018 Aug 31;403(5):547-554. Epub 2018 Jul 31.

Department of Surgery, Düsseldorf University Hospital, Düsseldorf, Germany.

Introduction: The definitive treatment of pilonidal sinus disease (PSD) is surgical. There is still no consensus as to the most appropriate off-midline primary closure technique. The aim of this meta-analysis has been to compare Karydakis flap reconstruction (KF) to Limberg flap transposition (LF) with regard to short- and long-term postoperative outcomes. Read More

J Med Ultrasound 2017 Oct-Dec;25(4):208-214. Epub 2017 May 3.

Department of Radiology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

Introduction: Anal pain is defined as pain originating from the anal canal or the perianal area that can be attributed to a variety of medical problems. The current study's aim was to evaluate the role of combined endoanal, transperineal, and in married women, transvaginal ultrasound in clarifying the etiology of anal pain among our patient study group.

Methodology: A total of 180 patients presented to our radiology department complaining of anal pain and were examined using transperineal, endoanal, and in women, transvaginal ultrasound aided with three-dimensional capability. Read More

Surgery 2018 Dec 29;164(6):1217-1222. Epub 2018 Jul 29.

University of Michigan, Ann Arbor, MI. Electronic address:

Background: The surgical treatment of pilonidal disease is highly variable. The present study examines the long-term results in over 500 patients treated by minimal but complete surgical excision under local anesthesia with healing by secondary intention using moist dressings.

Methods: Records of all patients I treated for pilonidal disease from 1978 to 2015 with at least 1 year of follow-up were reviewed. Read More

Int J Colorectal Dis 2018 Oct 30;33(10):1445-1452. Epub 2018 Jul 30.

Department General Surgery, Bogazici Academy of Clinical Sciences, 34357, Istanbul, Turkey.

Purpose: The aim of this study is to investigate the effect of triclosan-coated sutures on surgical site infections after wide excision and primary closure for pilonidal disease.

Methods: One hundred seventy-seven patients were randomized into two groups: 91 in control and 86 in triclosan groups. In the control group, 1/0 monofilament polypropylene retention sutures, 3/0 polyglactin subcutaneous sutures, and 3/0 polypropylene skin sutures were used. Read More

Cureus 2018 May 25;10(5):e2690. Epub 2018 May 25.

Wolfson Diabetes and Endocrine Clinic, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge University Hospitals Nhs Foundation Trust, Cambridge, Uk.

Trichogranuloma is a rare occupational disease of hairdressers that develops when hair clippings penetrate the skin and cause a foreign-body reaction. We describe a case of a hairdresser with limited cutaneous systemic sclerosis who developed a chronic felon on her right third finger and received repeated courses of antibiotics without improvement. An occupational history and awareness of occupational diseases in hairdressers led to the correct diagnosis of trichogranuloma. Read More

Cureus 2018 May 14;10(5):e2625. Epub 2018 May 14.

Colorectal Unit, Royal Prince Alfred Hospital.

Background Pilonidal disease is a common condition with no consensus for the best management of chronic disease or current practice in Australia and New Zealand. Methods A survey was distributed among 190 colorectal and 592 general surgeons in Australia and New Zealand. Data was obtained regarding pilonidal surgery volume, procedures performed, non-operative management and recurrence rates. Read More

Ned Tijdschr Geneeskd 2018 May 2;162. Epub 2018 May 2.

VieCuri Medisch Centrum, afd. Chirurgie, Venlo.

Background: Besides the natal cleft, a pilonidal sinus can also occur in other areas of the body. An uncommon place is the interdigital web space of the toes. A sinus can arise due to penetration of the skin by a hair. Read More

Int Wound J 2018 Oct 27;15(5):840-844. Epub 2018 Jun 27.

Acibadem University Medical Faculty, Department of Pediatric Surgery, Istanbul, Turkey.

Pilonidal sinus disease (PSD) is associated with a complex disease process in children, and its management remains controversial. There are a few published studies on PSD in the paediatric literature; therefore, we present our experience of conservatively treating PSD in children. This study involved a retrospective review with telephone follow up. Read More

Adv Skin Wound Care 2018 Jul;31(7):E1

Adv Skin Wound Care 2018 Jul;31(7):298-305

R. Gary Sibbald, MD, MEd, BSc, FRCPC (Med Derm), MACP, FAAD, MAPWCA • Professor • Medicine and Public Health • University of Toronto • Toronto, Ontario, Canada • Director • International Interprofessional Wound Care Course and Masters of Science in Community Health (Prevention and Wound Care) • Dalla Lana Faculty of Public Health • University of Toronto • Past President • World Union of Wound Healing Societies • Clinical Editor • Advances in Skin and Wound Care • Philadelphia, Pennsylvania Reneeka Persaud Jaimangal, MD, MScCH • Dalla Lana School of Public Health • University of Toronto • Research Coordinator • Toronto Regional Wound Healing Clinic • Adjunct Faculty • International Interprofessional Wound Care Course • Toronto, Ontario, Canada Patricia M. Coutts, RN • Registered Nurse • Wound Care and Clinical Trials Coordinator • Toronto Regional Wound Healing Clinic • Faculty • International Interprofessional Wound Care Course • Toronto, Ontario, Canada James A. Elliott, MSc • Faculty • International Interprofessional Wound Care Course • Member • Wounds Canada Research Committee • Toronto, Ontario, Canada.

General Purpose: To present an evaluation of a surfactant-containing polymeric membrane foam wound dressing for use on patients with chronic pilonidal sinus disease.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After completing this continuing education activity, you should be able to:1. Read More

Dis Colon Rectum 2018 07;61(7):777-779

Cleveland Clinic, Cleveland, Ohio.

Colorectal Dis 2018 Aug 27;20(8):O207-O214. Epub 2018 Jun 27.

Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.

Aim: Various surgical techniques are available for the management of pilonidal sinus, but there is still controversy concerning the optimal surgical approach. The aim of our study was to evaluate the safety, efficacy and clinical outcome of a laser procedure for the treatment of pilonidal sinus.

Method: Patients suffering from pilonidal sinus were operated on with sinus laser therapy (SiLaT) in our institute. Read More

Surg Infect (Larchmt) 2018 Aug/Sep;19(6):603-607. Epub 2018 Jun 5.

1 Department of Surgery, Nationwide Children's Hospital , Columbus, Ohio.

Background: Recurrent pilonidal disease has been reported to occur in up to 30% of patients after their initial infection. Surgical resection is often performed to prevent recurrence of disease, however, morbidity after surgical excision from incision complications and disease recurrence is common. The aim of this study was to quantify major morbidity after initial pilonidal excision. Read More

Tech Coloproctol 2018 05 31;22(5):325-331. Epub 2018 May 31.

Department of General Surgery, Colchester Hospital University Foundation Trust, Colchester, UK.

Background: Pilonidal sinus is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. More recently minimally invasive approaches have been described. Read More

Int Wound J 2018 Aug 21;15(4):534-537. Epub 2018 May 21.

Plastic Surgery Unit, St Andrew Centre for Burns and Plastics, Chelmsford, UK.

The reconstruction of defects in the intergluteal region following pilonidal sinus excision is challenging due to its anatomical location, close proximity to the anus, and being a high-tension area prone to wound-healing problems. Excision and primary closure is known to carry a higher risk of recurrence and subsequent complications compared with using nearby local healthy tissue, such as a flap, to reconstruct defect. Extra due diligence should be given to patient selection and flap choice when deciding the reconstruction of a defect. Read More

Dis Colon Rectum 2018 Jul;61(7):775-777

Department of General Surgery, Madigan Army Medical Center, Tacoma, Washington.

JSLS 2018 Apr-Jun;22(2)

Indus Super Specialty Hospital Mohali, India Garg Fistula Research Institute Haryana, India Tel: 0091-9501522000 E-mail:

J Craniofac Surg 2018 Sep;29(6):e556-e557

Pathology Clinic, Regional Training and Research Hospital, Erzurum, Turkey.

Pilonidal sinuses are recurrent chronic inflammatory lesions which may occur due to penetration of hair particles into skin. Herein, the authors report a pilonidal sinus case that is unusually seen on nasal dorsum and totally excised with the open technique rhinoplasty method. A 20-year-old male patient was admitted to the authors' outpatient clinic with complaints of dysmorphism and discharge from nasal dorsum. Read More

J Eur Acad Dermatol Venereol 2018 Oct 31;32(10):1784-1790. Epub 2018 May 31.

Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Background: The prevalence of hidradenitis suppurativa (HS) in Asia is unknown. The associations between HS and other autoimmune disorders have rarely been reported.

Objective: We sought to determine the prevalence of and diseases associated with HS using the National Health Insurance (NHI) database. Read More

Turk J Surg 2018 4;34(1):43-48. Epub 2018 Jan 4.

Department of General Surgery, Güven Hospital, Ankara, Turkey.

Objective: In the treatment of pilonidal sinus disease different approaches are used such as conservative treatment and fasciocutaneous rotation flap. The aim of this study was to evaluate the efficacy of "de-epithelialization technique" as a new approach in pilonidal sinus disease treatment.

Material And Methods: Forty pilonidal sinus disease patients treated with de-epithelialization method were evaluated retrospectively. Read More

Dis Colon Rectum 2018 06;61(6):e343

University "Federico II" of Naples, Department of Advanced Biomedical Sciences, Naples, Italy.

World J Surg 2018 11;42(11):3568-3574

Department of Plastic and Reconstructive Surgery, School of Medicine, Baskent University, Ankara, Turkey.

Backgrounds: Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Although many surgical methods have been described for treating pilonidal sinus disease, controversy still exists as to the best surgical technique. The aim of this study is to present a new modified advancement flap technique named "omega flap" for the treatment of pilonidal sinus disease. Read More

Surgeon 2018 Oct 24;16(5):315-320. Epub 2018 Apr 24.

Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via S. Pansini, 5, Naples, Italy.

Background: Sacrococcygeal pilonidal sinus disease (PSD) is a common chronic inflammation of the natal cleft and presents as an abscess or a chronically discharging, painful sinus tract. The management of chronic PSD is variable, contentious, and problematic. Although many surgical procedures have been tried, the best surgical method remains controversial. Read More

A A Pract 2018 Oct;11(8):227-229

Department of Anesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.

National or international guidelines can help surgeons and anesthesiologists make treatment decisions, but the existence of conflicting recommendations can hinder treatment rather than helping. A case in point is the treatment of pilonidal sinus disease, a chronic subcutaneous infection located in the sacrococcygeal area. Its incidence is rising, reaching almost 100/100,000 inhabitants. Read More

Arch Iran Med 2018 Mar 1;21(3):131-133. Epub 2018 Mar 1.

Department of General Surgery, Ministry of Health, Numune Teaching and Research Hospital, Adana, Turkey.

Pilonidal sinus, including one or more sinus canals and hairs, is a disease with a chronic course showing acute attacks which is often encountered in the general population, usually affecting young adults, at a rate in males twice that of females. Pilonidal sinus on the penis is so rare that very few cases have been reported in literature. A 20-year-old male presented to the urology outpatient clinic with the complaint of a suppurative lesion with discharge on the skin of the penis which had been ongoing for approximately three months. Read More

Pediatr Surg Int 2018 Jun 19;34(6):687-692. Epub 2018 Apr 19.

Proctological Unit, Department of General Surgery, Sestri Levante Hospital, Genoa, Italy.

Background: Pilonidal disease is a troublesome acquired condition for whom various surgical treatments have been proposed with relatively high recurrence and complication rates. Since EPSiT technique has been described in 2013, it became an alternative treatment in adult practice. Our study reports the results of a multicentre series of pediatric patients who underwent EPSiT procedure over a 21-month period. Read More