Are the concerns of surgeons about cosmetic outcomes in pilonidal disease surgery more than necessary?

Aim: Pilonidal disease is a chronic inflammatory process. From time to time poor cosmetic results can be obtained after surgery. In this study, it was aimed to investigate the effects of cosmetic results and the satisfaction level of the cases in patients who underwent surgery with different surgical techniques due to pilonidal disease.Material and Methods: The information about study was given to cases, which were operated due to pilonidal disease between January 2014 and December 2014 and could be contacted by phone. The questionnaire was applied to 125 cases who agreed to participate in the study. Cases were divided into two groups as primary excision with midline closure applied group and other surgical techniques applied group. The questions about the postoperative results were asked to the cases.Results: There was no statistically significant difference between the two groups in terms of pain duration, painless sitting-walking times, time to return to daily life, complications, reoperation rates and patient satisfaction of surgical scar. It was detected that there was more recurrence in the primary excision group and the results were statistically significant (p = 0.038). In the both groups, it was found that there is no statistically significant difference in the satisfaction questionnaire on surgical scar. (p> 0.05).Conclusions: The surgical scar can cause significant cosmetic problems in surgery treatment of pilonidal disease. Poor cosmetic results on cases may sometimes be more important. The results of this study showed that patients care more about the functional outcomes of treatment than the cosmetic results.

PDF

___

1. Saydam M, Ozturk B, Sinan H, et al. Comparison of modified Limberg flap transposition and lateral advancement flap transposition with Burow’s triangle in the treatment of pilonidal sinus disease. Am J Surg 2015;210:772-7.
2. McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 2008;336:868-71.
3. Demircan F, Akbulut S,Yavuz R, et al. The effect of laser epilation on recurrence and satisfaction in patients with sacrococcygeal pilonidal disease: a prospective randomized controlled trial.Int J Clin Exp Med 2015;8:2929-33.
4. Khanna A, Rombeau JL. Pilonidal Disease. Clin Colon Rectal Surg 2011;24:46-53.
5. Tavassoli A, Noorshafiee S, Nazarzadeh R. Comparison of excision with primary repair versus Limberg flap. Int J Surg 2011;9:343-6.
6. Okuş A, Sevinç B, Karahan O, et al. Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery. World J Surg 2012;36:431-5.
7. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 1992;62:385-9.
8. Ballas K, Psarras K, Rafailidis S, et al. Interdigital pilonidal sinüs in a hair-dresser. J Hand Surg 2006;31:290-1.
9. Enriquez-Navascues JM, Emparanza JI, Alkorta M, et al. Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinüs. Tech Coloproctol 2014;18:863-72.
10. Singh R, Pavithran NM. Adipo-fascio-cutaneous Flaps in the Treatment of Pilonidal Sinus: Experience with 50 Cases. Asian J Surg 2005;28:198-201.
11. Polat C, Gungor B, Karagul S, et al. Is oval flap reconstruction a good modification for treating pilonidal sinuses? Am J Surg 2011;201:192-6.
12. Akinci OF, Kurt M, Terzi A, et al. Natal cleft deeper in patients with pilonidal sinus: implications for choice of surgical procedure. Dis Colon Rectum 2009;52:1000-2.
13. Armstrong JH, Barcia PJ. Pilonidal sinus disease. The conservative approach. Arch Surg 1994;129:914-9.
14. Odili J, Gault D. Laser depilation of the natal cleft: an aid to healing the pilonidal sinus. Ann R Coll Surg Engl 2002;84:29-32.
15. Dogru O, Camci C, Aygen E, et al. Pilonidal sinus treated with crystallized phenol: an eight-year experience. Dis Colon Rectum 2004;47:1934-8.
16. Akin M, Leventoglu S, Mentes BB, et al. Comparison of the classic Limberg flap and modified Limberg flap in the treatment of pilonidal sinus disease: a retrospective analysis of 416 patients. Surg Today 2010;40:757-62.