D. R. Halleran1,2, J. J. Lopez1,2, A. E. Lawrence1,2, K. L. Leonhart2, Y. V. Sebastião2, B. A. Fischer2, J. N. Cooper2, P. C. Minneci1,2, K. J. Deans1,2 1Nationwide Children’s Hospital,Division Of Pediatric Surgery,Columbus, OH, USA 2Nationwide Children’s Hospital,The Center For Surgical Outcomes Research,Columbus, OH, USA
Introduction: Pilonidal disease is a common and painful disorder among adolescents and young adults, affecting males at a rate of 2 to 4 times that of females. Approximately 1% of the population will be diagnosed with pilonidal disease between the ages of 15-30 years. Patients with recurrent pilonidal disease can develop chronic wounds and draining sinuses that incur long term morbidity, disability, and decreased quality of life. Recurrence rates have been conservatively reported at 16% and as high as 30%. The aim of this study was to characterize rates of recurrence in patients with pilonidal disease treated by pediatric surgeons.
Methods: We conducted a retrospective review of patients at our institution diagnosed with pilonidal disease and evaluated by surgery from 2010-2015. Demographic and clinical characteristics were collected from the electronic medical record. Summary measures were used to examine patient demographics and clinical outcomes. This study was approved by our institutional review board.
Results: In 360 patients with pilonidal disease treated at our institution over the study period, 51% were male with a median age at initial evaluation of 16 years (IQR 14-17) and a median BMI of 28.3 kg/m2 (23.5-34.0). Recurrent pilonidal disease was seen in 34.4% of the patients in our cohort with approximately 22% of patients having a recurrence within the first year of initial evaluation (Table). In patients treated after their first episode of disease, recurrence rates were 21.3% after treatment with antibiotics only, 26.8% after treatment with incision and drainage, and 30.4 % after surgical excision. Approximately 66% of patients underwent surgical excision of their pilonidal disease in our cohort.
Conclusion: Pilonidal disease has a substantial recurrence rate even after surgical excision. Future studies investigating treatments that can prevent disease recurrence are needed.
