Surgery for asymptomatic pilonidal sinus disease

Doll, Dietrich; Friederichs, Jan; Düsel, Wolfgang; Fend, Falko; Petersen, Sven
September 2008
International Journal of Colorectal Disease;Sep2008, Vol. 23 Issue 9, p839
Academic Journal
Asymptomatic pilonidal sinus disease (PSD) discovered incidentally is regarded as a precursor of symptomatic disease, which is characterized by intradermal hair eliciting an inflammatory reaction. We aimed to investigate whether asymptomatic PSD already shows inflammation, though clinically inapparent, or represents a ‘virgin’ sinus. One thousand seven hundred and thirty-one medical records of patients presenting with primary PSD, which underwent surgery, were analysed to identify patients with surgically resected incidental PSD. Acute purulent pilonidal disease was seen in 514 of 1,731, whereas chronic fistulating pilonidal disease was the most common diagnosis group with 1,019 of 1,731 (58.9%). One hundred and forty-three of 1,731 (8.3%) patients had a previous chronic remitting pilonidal sinus. A total of 55 (3.2%) patients with clinically asymptomatic PSD were identified. Histological workup documented hair in 64.6% (1,119/1,731), with comparable rates between 68% and 71% in chronic fistulating disease, chronic remitting disease and incidental PSD ( p = 0.80). Inflammation was found in 53 of 55 (96.4%) incidental PSD specimens, with two thirds (37 of 55) showing chronic inflammatory changes and one third (16 of 55) combining acute and chronic inflammation. Our findings support the idea that incidental PSD is a sub-clinically inflamed pilonidal sinus, with hair and chronic infection present. However, the data suggest that a prophylactic surgery for asymptomatic PSD provides no benefit for the patient compared to surgery in chronic PSD; thus, observational treatment is most likely sufficient for asymptomatic PSD.


Related Articles

  • Rhomboid flap for the management of recurrent pilonidal disease. Jethwani, Umesh // New Indian Journal of Surgery;Oct2011, Vol. 2 Issue 4, p322 

    Background Pilonidal sinus is a common chronic disease of the sacrococcygeal region. The treatment varies according to the clinical presentation of the disease. Although many surgical methods have been suggested, an ideal method is still lacking because of high recurrence rates. The aim of this...

  • Comparison of Karydakis technique with Limberg Flap Procedure in Pilonidal Sinus Disease: Advantages of Karydakis technique. Bostanoglu, Settar; Sakcak, Ibrahim; Avsar, Fatih Mehmet; Cosgun, Erdal; Hamamci, Enver Okan // Pakistan Journal of Medical Sciences;Oct2010, Vol. 26 Issue 4, p773 

    Objective: Several surgical techniques are being performed in the treatment of pilonidal sinus disease; however there is no single agreed technique that could be used in all patients. In this study we compared the results of the patients on which we implemented Karydakis Technique and Limberg...

  • Therapeutic approaches to patients with pilonidal sinus based on specific clinical characteristics. Galati, Gaspare; Sterpetti, Antonio; Tartaglia, Elvira; Basso, Luigi; Nicolanti, Virgilio // European Journal of Plastic Surgery;Nov2012, Vol. 35 Issue 8, p595 

    Controversies exist about the optimal treatment for patients with pilonidal disease. Our therapeutic approach to patients with this condition has been conservative treatment. Surgery was performed only after failure of conservative treatment. Surgery consisted of excision of the sinus and...

  • Pilonidal Sinus Disease: A 5-year Study. Matar, Zafer Said // Internet Journal of Surgery;2007, Vol. 13 Issue 2, p2 

    Background: Even though there are different surgical treatments for pilonidal sinus, the outcome may not be uniformly satisfactory. Recurrent disease is a significant cause of morbidity and loss of workdays and has to be prevented. Materials and methods: One hundred and ten patients were...

  • Pilonidal sinus disease: a review. Part one. Bradley, L. // Journal of Wound Care;Nov2010, Vol. 19 Issue 11, p504 

    This article is in two parts. The overall aim is to review the literature relating to the management of pilonidal sinus disease and to explore the impact the disease has on those who suffer with it, predominantly young people. Part one reviews the literature and provides the rationale for the...

  • Day-Case Limberg Flap for Recurrent Pilonidal Sinus: Does Obesity Complicate the Issue? MADBOULY, KHALED M. // American Surgeon;Sep2010, Vol. 76 Issue 9, p995 

    The purpose of this study was to analyze the long-term outcome of rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on outcome will be addressed. Forty-nine patients with RPS were treated by rhomboid...

  • Pilonidal cyst of the male breast: barber's disease. Hughes, Rebecca; Iqbal, Fahad M.; Salem, Fathi; Vidya, Raghavan // British Journal of Hospital Medicine (17508460);Oct2016, Vol. 77 Issue 10, p599 

    The article describes the case of pilonidal cyst in a 38-year-old man and discusses the causes and prevention of pre-aerolar pilonidal disease.

  • Bascom's cleft lift versus rhomboid flap procedure for the management of primary sacrococcygeal pilonidal sinus. Rabea, Mohamed // Egyptian Journal of Surgery;Jul2015, Vol. 34 Issue 3, p146 

    Objective The aim of this study was to evaluate and compare clinical safety and effi cacy after Bascom's cleft lift and rhomboid fl ap (Limberg) procedures for the treatment of primary sacrococcygeal pilonidal sinus (SCPS). Patients and methods This study included 100 adult patients with primary...

  • Lateral Incision Surgery for Pilonidal Sinus: Death of a Dogma. Cheetham, Mark // World Journal of Surgery;Feb2012, Vol. 36 Issue 2, p436 

    The article presents the author's comments on the study "Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery," by A. OkuÅŸ and colleagues, published in the current issue. The author believes that further investigation is required on the surgery process...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics