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The influence of lifestyle (smoking and body mass index) on wound healing and long-term recurrence rate in 534 primary pilonidal sinus patients

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

With pilonidal sinus disease (PSD) incidence increasing, lifestyle issues have been suspected to be responsible to worsen the results of PSD surgery at the same time. The influence of smoking and body mass index (BMI) on long-term recurrence rate in primary PSD surgery has not been investigated yet.

Methods

A total of 534 patients (German military cohort) were analyzed, comparing the wound healing rates of non-smoker with smoker, as well as recurrence rates in either groups. Simultaneously, the impact of BMI on wound healing and recurrence was studied. Recurrence rate was determined by Kaplan–Meier calculation following up to 20 years after primary PSD surgery.

Results

Using primary open surgery, smokers’ and non-smokers’ recurrence rates did not differ statistically (p = 0.83; log rank). Comparable rates occurred following the primary midline closure technique (p = 0.14; log rank). A BMI of 25 and higher was not associated with adverse wound healing neither in the primary midline closure (p = 0.14) nor in the primary open treatment group (p = 0.3); nevertheless, a trend may be seen that a BMI of 25 and above could assist a favorable wound healing rate.

Conclusions

The lifestyle parameter smoking and body weight statistically do not complicate wound healing or long-term recurrence rates for the first 20 years following primary PSD surgery in this study. As the BMI of 25 and above may have a beneficial influence on wound healing in primary open and primary midline closure, this observation has to be investigated for the today’s surgical procedures of elective first choice-asymmetrical and flap procedures.

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Conflict of interest

We have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Military Hospital Berlin, Academic Teaching Hospital of the Charité, Berlin, Germany

    Heidi Sievert, Theo Evers & Dietrich Doll

  2. Klinikum rechts der Isar, Department of Surgery, Technische Universität München, Munich, Germany

    Edouard Matevossian

  3. Department of Anaesthesiology and Intensive Care, St.-Marien-Hospital Vechta, Teaching Hospital of the MHH Hannover University, Vechta, Germany

    Christian Hoenemann

  4. Department of Visceral, Thoracic and Vascular Surgery, Philipps-University of Marburg, Marburg, Germany

    Sebastian Hoffmann & Dietrich Doll

  5. Department of Surgery, St.-Marien-Hospital Vechta, Teaching Hospital of the MHH Hannover University, Vechta, Germany

    Dietrich Doll

  6. Department of Anaesthesiology and Intensive Care, Dietrich-Bonhoeffer-Hospital Neubrandenburg, Academic Teaching Hospital of the Ernst-Moritz-Arndt University of Greifswald, Neubrandenburg, Germany

    Heidi Sievert

  7. Department of ENT and Maxillo-Facial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Ulm, Germany

    Theo Evers

  8. Department of Surgery, St.-Marien-Hospital Vechta, Academic Teaching Hospital of The Hannover University, Marienstr. 6-8, 49377, Vechta, Germany

    Dietrich Doll

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  1. Heidi Sievert
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  2. Theo Evers
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  3. Edouard Matevossian
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  4. Christian Hoenemann
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  5. Sebastian Hoffmann
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  6. Dietrich Doll
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Correspondence to Dietrich Doll.

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This paper has not been submitted anywhere else. It has not been presented on a meeting or podium.

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Sievert, H., Evers, T., Matevossian, E. et al. The influence of lifestyle (smoking and body mass index) on wound healing and long-term recurrence rate in 534 primary pilonidal sinus patients. Int J Colorectal Dis 28, 1555–1562 (2013). https://doi.org/10.1007/s00384-013-1731-8

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  • DOI: https://doi.org/10.1007/s00384-013-1731-8

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