Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
Dietrich DollAlexander Novotny

Abstract

The purpose of this study was to examine the recurrence rate of wound rupture in primary pilonidal sinus disease (PSD) after median closure. A total of 583 patients from the German military cohort were interviewed. We compared the choice of surgical therapy, wound dehiscence (if present) and long-term recurrence-free survival for patients with primary open treatment, marsupialization and primary median treatment (closed vs. secondary open, respectively). Actuarial recurrence rate was determined using the Kaplan-Meier calculation with a follow-up of up to 20 years after primary PSD surgery. Patients with excision followed by primary open wound treatment showed a significantly lower 5- than 10-year recurrence rate (8.3 vs. 11.2%) compared to the patients with primary midline closure (17.4 vs. 20.5%, p = 0.03). The 20-year recurrence rate was 28% in primary open wound treatment versus 44% in primary midline closure without wound rupture. In contrast to these findings, long-term recurrence rates following secondary open wound treatment (12.2% at 5 years vs. 17.1% at 10 years) tended to be higher (although not significantly, p = 0.57) compared to primary open treatment (8.3% at 5 years vs. 11.2% at 10 years). There was no statistica...Continue Reading

Citations

Jan 15, 2019·Diseases of the Colon and Rectum·Eric K JohnsonUNKNOWN Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons
Jun 20, 2019·Frontiers in Pediatrics·Ana Isabel OliveiraJorge Correia-Pinto

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