The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR)
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The Italian Society of Colorectal Surgery (SICCR.) has prepared clinical practice guidelines to help its members to optimize the treatment of pilonidal disease, a very common condition, especially among young people, and therefore of great importance on a socioeconomic level. The SICCR committee of experts on pilonidal disease analyzed the international literature and evaluated current evidence. Nonoperative management includes gluteal cleft shaving, laser epilation as well as fibrin glue and phenol injection: reported healing rates and recurrence incidence are satisfactory but the majority of studies are small series with low-quality evidence. Surgical therapy which can be divided into two categories: excision of diseased tissue with primary closure using different techniques or excision with healing by secondary intention. On the whole, no clear benefit is demonstrated for one technique over the other.
KeywordsPilonidal disease Pilonidal sinus Pilonidal cyst Pilonidal abscess Recurrence Gluteal cleft
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research comitee and with the 1964 Helsinky declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all participants included in the study.
- 11.Al-Khamis A, Mc Callum I, King PM, Bruce J (2010) Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev 20:CD006213Google Scholar
- 24.Andersson RE, Lukas G, Skulmann S, Hugander A (2010) Local administration of antibiotics by gentamicin-collagen sponge does not improve wound healing or reduce recurrence rate after pilonidal excision with primary suture: a prospective randomized controlled trial. World J Surg 34:3042–3048CrossRefPubMedGoogle Scholar
- 35.Hameed KK (2001) Outcome of surgery for chronic natal cleft pilonidal sinus: a randomized trial of open compared with closed technique. J Coll Physicians Surg Pak 11:32–35Google Scholar
- 38.Grandjean JP, Al Nashawati G (1996) Traitement de la maladie pilonidale par excision large et cicatrisation dirigée. Lyon Chir 92:292–295Google Scholar
- 46.Biter UL, Beck GMN, Mannaerts G, Stok MM, van der Ham AC, Grotenhuis BA (2014) The use of negative-pressure wound therapy in pilonidal sinus disease: a randomized controlled trial comparing negative-pressure wound therapy versus standard open wound care after surgical excision. Dis Colon Rectum 57:1406–1411CrossRefPubMedGoogle Scholar
- 49.Buie LA, Curtiss RK (1952) Pilonidal sinus. Surg Clin North Am 32:1247–1259Google Scholar
- 75.Brusciano L, Limongelli P, Del Genio G, Tolone S, Amoroso V, Docimo G (2015) D-shape asymmetric excision of sacrococcygeal pilonidal sinus with primary closure, suction drain, and subcuticular skin closure: an analysis of risks factors for long-term recurrence. Surg Innov 22:143–148CrossRefPubMedGoogle Scholar
- 76.Doll D, Evers T, Krapohl B, Matevossian E (2013) Is there a difference in outcome (long-term recurrence rate) between emergency and elective pilonidal sinus surgery? Min Chir 68:199–205Google Scholar