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Time and rate of sinus formation in pilonidal sinus disease

Abstract

Background and aims

To elicit mechanisms and timing of sinus development, the role of age at onset of symptoms, symptomatic disease duration, and consecutive number of sinuses were investigated.

Materials and methods

Analysis of 1,962 medical records of patients admitted for primary surgical pilonidal sinus treatment.

Results

Sinus number ranged from 1 to 16 (median 2), with chronic pilonidal disease showing more sinuses than acute disease (mean 2.6 vs 2.1 sinuses; p < 0.0001; Kolmogorov–Smirnov). Disease duration in chronic pilonidal disease was not linked to sinus formation (p = 0.98; Spearman). In acute pilonidal disease, duration was linked to the development of six sinuses per 1,000 symptomatic disease years (p = 0.0001; Spearman). A larger sinus number correlated with earlier onset of symptoms (p = 0.009; Spearman).

Conclusion

Long-standing chronic disease does not produce sinus per se. As sinus does not substantially arise during the course of symptomatic disease, there must be a time before the start of symptomatic disease when the sinus originates.

These findings suggest that sinus can only be acquired up to a certain age, even if occupational exposure continues.

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Acknowledgment

This manuscript fully consists of original material, which has not been published or submitted to another journal. All authors declare that they participated in the study as specified below and that they have seen and approved the final version.

Conflict of interest statement

None of the authors has any conflicts of interest. No funds/grants/company gifts have been received, nor has the article been written by a third party.

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Correspondence to Dietrich Doll.

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Doll, D., Friederichs, J., Dettmann, H. et al. Time and rate of sinus formation in pilonidal sinus disease. Int J Colorectal Dis 23, 359–364 (2008). https://doi.org/10.1007/s00384-007-0389-5

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Keywords

  • Pilonidal sinus
  • Etiology
  • Growth and development
  • Epidemiology