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J Laparoendosc Adv Surg Tech A 2019 Apr 13. Epub 2019 Apr 13.

Pediatric Surgery Unit, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.

Background: The traditional open excision of pilonidal sinus disease (PSD) is associated with a painful postoperative course and high recurrence rates. We recently published our technique of pediatric endoscopic pilonidal sinus treatment (PEPSiT). We aimed to report our long-term outcome including using PEPSiT for recurrent PSD after failed open repair. Read More

J Pediatr Surg 2019 Mar 16. Epub 2019 Mar 16.

Department of General Surgery, Royal Derby Hospital, Derby, UK DE22 3NE; Department of Surgery, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK DE22 2DT.

Background: Pilonidal sinus disease (PNS) is not uncommon in children. Controversy remains over the best treatment and there is limited evidence. This systematic review and meta-analysis aims to establish which techniques have the best outcomes in children. Read More

Int Wound J 2019 Apr 1. Epub 2019 Apr 1.

Department of General Surgery, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey.

Pilonidal sinus disease is a common disorder. We aimed to evaluate the effects of perioperative antibiotherapy on surgical site infections in pilonidal sinus patients who were treated with rhomboid excision with Limberg transposition procedure. A total of 104 patients between 18 and 40 years of age (52 males, 52 females) were included in the study. Read More

BMJ Case Rep 2019 Mar 31;12(3). Epub 2019 Mar 31.

Radiology, Eastbourne District General Hospital, Eastbourne, UK.

Pilonidal disease is a common condition, typically occurring in the natal cleft of adult males. Other sites of pilonidal sinus are rarely reported. We report a case of periareolar pilonidal abscess in the breast of a 52-year-old woman who presented via the breast clinic complaining of nipple inversion and pain. Read More

Contact Dermatitis 2019 Mar 28. Epub 2019 Mar 28.

Department of Dermatology, Saint Eloi Hospital, University Hospital Center of Montpellier, France.

A 28-year-old female patient underwent surgery for buttock synechias as a result of previous surgery for pilonidal sinus. She was positioned prone during the reconstructive surgery. This article is protected by copyright. Read More

Br J Dermatol 2019 Mar 27. Epub 2019 Mar 27.

ResoVerneuil, Paris, France.

Background: Hidradenitis suppurativa (HS), also referred to as acne inversa, is a debilitating skin disease characterized by inflammatory nodules, chronic abscesses and tunnels (fistulae and sinuses). The association with pilonidal sinus disease is frequently reported but not well documented.

Objective: To determine the prevalence and characteristics of inflammatory skin lesions located in the intergluteal fold (IGF) of HS patients. Read More

Updates Surg 2019 Mar 18. Epub 2019 Mar 18.

Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy.

Sacrococcigeal pilonidalis disease (SPD) recurrence is a major factor influencing surgical outcomes. Several different surgical treatments have been reported, however, there is a lack of long-term data on reoperation. Aim of this study was to analyze outcomes of a single center adopting a standardized off-midline asymmetric procedure (D-shape). Read More

Int J Colorectal Dis 2019 Apr 27;34(4):561-568. Epub 2019 Feb 27.

St Helens and Knowsley NHS Foundation Trust, Whiston Hospital, Rainhill, Prescot, L35 5DR, England.

Background: Pilonidal sinus disease (PD) is a chronic condition involved in natal cleft. Excision surgery carries equally morbid course of recovery to that of disease itself. Minimally invasive treatments therefore have been developed to minimise morbidity and improve healing rates. Read More

Dtsch Arztebl Int 2019 Jan;116(1-2):12-21

München Klinik Bogenhausen; Center of Coloproctology Essen.

Background: Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal cleft. Its incidence in Germany in 2012 was 48 cases per 100 000 persons per year.

Methods: This review is based on pertinent publications retrieved by a selective literature search. Read More

Prague Med Rep 2018;119(4):148-155

Department of General Surgery, Okan University Medicine Faculty, Istanbul, Turkey.

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Read More

G Chir 2019 Jan-Feb;40(1):70-74

Aim: We report a case of squamous carcinoma arising from a pilonidal sinus.

Case Report: Patient of 83 years old, that after 30 years had a recurrence of pilonidal sinus revealed by a sacral abscess studied with pelvic CT scan and MRI. After clinical investigation, traditional open surgical technique was performed and pathologic studies revealed a squamous carcinoma. Read More

Int J Colorectal Dis 2019 Apr 4;34(4):741-746. Epub 2019 Feb 4.

Department of Surgery, EOC Hospital, Mendrisio, Switzerland.

Background: Pilonidal disease (PD) 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. Recurrent PD after surgical treatment is frequent event for the 25-30% of cases. Read More

Asian J Surg 2019 Jan 30. Epub 2019 Jan 30.

Memorial Oncology Group, Medstar Antalya Hospital, Department of General Surgery, Antalya, Turkey.

To identify surgical techniques applied in case of recurrence in patients with pilonidal sinus, who have undergone primary treatment with Limberg flap, and to present our cases treated with Limberg flap reconstruction prepared from the contralateral gluteal region. Nine patients with recurrence out of 219 patients who underwent Limberg flap reconstruction between 2009 and 2016 at our clinics, and 6 patients who have been referred to our clinics with total 15 recurrence after primary Limberg flap reconstruction at other institutes were included in the study. Total excision and primary repair was applied in 3 patients while 2 patients underwent excision with lay open procedures. Read More

Can J Surg 2019 04;62(2):131-138

From the Department of General and Colorectal Surgery, Diana, Princess of Wales Hospital, Northern Lincolnshire and Goole, Grimsby, UK.

Background: The Limberg flap reconstruction and the Karydakis flap reconstruction are the 2 most used off-midline closure techniques in pilonidal sinus surgery. The current evidence is inconclusive as to which is the optimal technique. The aim of this systematic review and meta-analysis was to compare differences in outcomes between these 2 flap-based techniques. Read More

Asian J Surg 2019 Jan 23. Epub 2019 Jan 23.

Okan University, General Surgery Department, İstanbul, Turkey. Electronic address:

Objectives: Although many surgical methods have been described for sacrococcygeal pilonidal sinus treatment, the best option is still controversial. We aimed to compare postoperative outcomes of these different methods in terms of advantages and disadvantages.

Methods: The records of 320 patients undergone surgery for primary or recurrent pilonidal sinus between May 2013 and May 2017 were retrospectively analyzed. Read More

J Pediatr Surg 2019 Jan 5;54(1):174-176. Epub 2018 Oct 5.

Department of Surgery, Boston Children's Hospital, Boston, MA, USA.

Purpose: The purpose of the study was to evaluate the outcome of pit-picking on adolescents with pilonidal disease.

Methods: Patients presenting to a Pilonidal Clinic were managed by evacuation of any un-drained collections, soaking, and as needed, hair removal. Once active inflammation resolved, they underwent pit-picking under local anesthesia. Read More

Dis Colon Rectum 2019 02;62(2):146-157

Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

Diagn Interv Radiol 2019 Jan;25(1):21-27

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. Read More

Updates Surg 2019 Mar 12;71(1):179-183. Epub 2018 Dec 12.

Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.

Since its first description in 1883, different treatments for pilonidal sinus disease have been proposed, but we are still far from the identification of an ideal approach. The objective of this study is to determine if video-assisted ablation of pilonidal sinus (VAAPS) could be considered superior/non-inferior to standard sinusectomy for treatment of pilonidal sinus disease. After applying propensity score analysis, data from 40 patients who underwent sinusectomy and 40 patients who underwent VAAPS, from March 2011 to August 2013, were collected. Read More

Med Sci Monit 2018 Dec 11;24:8959-8963. Epub 2018 Dec 11.

Department of General Surgery, Hitit University School of Medicine, Çorum, Turkey.

BACKGROUND Pilonidal sinus (PS) is a common disease of the sacrococcygeal-natal region. There are many treatment options, but there is still no consensus on the ideal treatment. We compared the results of our PS patients who were treated with primary midline closure (PMC), Limberg flap repair (LFR), and Karydakis flap (KF). Read More

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

Int Wound J 2019 Apr 15;16(2):370-378. 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 10 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 12;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 10 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 2019 Jan 5;101(1):21-29. 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

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

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

Indus Super Specialty Hospital, Mohali, India.

Turk J Surg 2018 Aug 28;34(4):311-314. Epub 2018 Aug 28.

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

Objective: 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

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 11 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

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

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