Pilonidal sinus disease.
Abstract: Pilonidal disease is a frequent suppurative condition that occurs twice as often in men as in women, usually between the ages of 15 and 30. Pilonidal disease is located beneath the skin of the sacro-coccygeal region. It presents acutely as an abscess under tension while the chronic form gives rise to intermittent discharge from pilonidal sinus(es). Diagnosis is clinical and usually straightforward. In the large majority of cases, treatment is surgical but there is no consensus as to the 'ideal' technique. Acute abscess must be evacuated and an off-midline incision seems preferable. Excision is the standard definitive treatment but the choice of wide versus limited excision depends on the school of thought. The widespread practice in France is to leave the wound open, relying on postoperative healing by secondary intention. This technique has a low rate of recurrence but has the disadvantages of requiring local nursing care; the healing process is prolonged, usually associated with a temporary but prolonged cessation of activity. Primary wound closure techniques are less restrictive but their recurrence rate is probably higher. A direct midline suture is best after a small excision, but for a more extended wound, plastic reconstruction techniques are preferred; data in the literature favor asymmetric closure techniques such as those described by Karydakis and Bascom.
Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Publication Date: 2013-08-01 PubMed ID: 23911903DOI: 10.1016/j.jviscsurg.2013.05.006Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Review
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research article delves into the diagnosis and treatment of sinus diseases in horses, underlining the complications that arise due to the substantial size of the sinuses, complex anatomy, and the advanced state of many diseases at the time of diagnosis. The researchers highlight the advancement in diagnostic methods and the enhancements available for treating various sinus disorders.
Diagnostic Challenges
- The article addresses the challenges in diagnosing and treating diseases in the paranasal sinuses and conchae of horses. The large size of these structures in horses, coupled with their intricate anatomy and the limited accessibility, makes the diagnosis complex.
- Further, these diseases are often diagnosed at an advanced stage, which poses more complications in the treatment.
Improved Diagnostic Methods
- The article points to the development of more effective diagnostic methods to address these challenges. Techniques such as nuclear scintigraphy, computed tomography, and direct endoscopy of the sinuses are identified as efficient methods for diagnosing diseases in these complex structures.
Treatment options
- The research also suggests various advancements in the treatment of sinus diseases in horses. Direct sinus endoscopy is recognized as an effective tool for addressing focal lesions.
- For treating diffuse sinus lesions, the use of large frontal bone flaps is identified as an improved approach.
- The authors also recommend standing surgery through a frontal flap as a viable solution for diverse sinus disorders.
- Lastly, the paper discusses the use of intralesional formalin as an increasingly effective treatment for progressive ethmoidal hematomas.
Conclusion
- This research thus provides a comprehensive account of the complications in diagnosing and treating sinus diseases in horses and proposes improved methods for overcoming these challenges.
Cite This Article
APA
de Parades V, Bouchard D, Janier M, Berger A.
(2013).
Pilonidal sinus disease.
J Visc Surg, 150(4), 237-247.
https://doi.org/10.1016/j.jviscsurg.2013.05.006 Publication
Researcher Affiliations
- Service de proctologie médico-chirurgicale, institut Léopold-Bellan, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France. Electronic address: iplb@hpsj.fr.
MeSH Terms
- Biopsy
- Global Health
- Humans
- Incidence
- Pilonidal Sinus / diagnosis
- Pilonidal Sinus / epidemiology
- Pilonidal Sinus / surgery
- Surgical Flaps
- Surgical Procedures, Operative / methods
- Wound Healing
Citations
This article has been cited 60 times.- Darbandi MF, Hoy M, Retrosi G. Advancing pilonidal disease care through pediatric endoscopic treatment (PEPSiT): early insights. Pediatr Surg Int 2026 Feb 27;42(1).
- Grgić T, Grgić D, Žulec M, Rašić F, Zadro Z, Golubić K, Šemanjski K. LASER SURGERY FOR PILONIDAL DISEASE - A NOVEL MINIMALLY INVASIVE PROCEDURE. Acta Clin Croat 2025 Mar;64(1):157-161.
- de Kort J, Pronk AA, van Dijk MR, Maaskant A, Vriens MR, Smakman N, Furnee EJB. Etiologic factors in developing sacrococcygeal pilonidal sinus disease in males; A cased-control study. Langenbecks Arch Surg 2025 Oct 28;410(1):315.
- Ni J, Yang Y, Liu Q, Deng Y, Zhou R, Zhu L, Li Y, Wang Z, Han C. A promising novel material-light-cured wound closure adhesives promote wound healing after pilonidal sinus open surgery: a Case Report. Front Bioeng Biotechnol 2025;13:1635598.
- Hawezy DJ. Comparison of Simple Drainage Versus Drainage With Tract Destruction in the Management of Pilonidal Abscess. Cureus 2025 Sep;17(9):e91699.
- Lagus J, Myllykangas HM, Nuutinen H. Comparative analysis of treatment modalities and contributing factors in recurrent pilonidal sinus disease. Exp Ther Med 2025 Nov;30(5):219.
- Haouari MA, Gallégo C, de Parades V, Fite C, Touloupas C, Delpla A, Bouley-Coletta I, Zins M. Imaging of perineal suppurations: a pictorial essay. Abdom Radiol (NY) 2026 Feb;51(2):1046-1070.
- Yacoub H, Aqel A, Adas M, Hjouj Q, Yacoub Z, Yacoub R, Dababseh H. Extremely Rare Presentation of Pilonidal Sinus Disease in the Posterior Cranial Fossa of a 2-Year-Old Patient: A Case Report. J Neurol Surg Rep 2025 Jul;86(3):e149-e152.
- Wijekoon S, Dissanayake H, Dehigama U, Senevirathna J, Gamage H, Surage NPM, Godakanda GKPM, Wijesinghe K. A scoping review on clinicopathological characteristics, diagnosis, and management of intermammary pilonidal sinus disease. Womens Health (Lond) 2025 Jan-Dec;21:17455057251351739.
- Kılıç AB, Muti Acar MN, Kılıç S, Ekingen G. Evaluation of phenol treatment for pilonidal sinus in adolescents. Front Pediatr 2025;13:1595749.
- Ouali M. SiLaC® with EPSiT®: early outcomes of laser-endoscopic therapy for pilonidal sinus. Front Surg 2025;12:1587467.
- Al Ani A, Dawara M, Bachir R, Dawara SA, Al Rubaye F. Pilonidal Sinus in the Cheek: A Report of a Rare Case. Cureus 2025 Mar;17(3):e80840.
- Aimar K, Baker DM, Li E, Lee MJ. Lived experience of pilonidal sinus disease: Systematic review and meta-ethnography. Colorectal Dis 2025 Jan;27(1):e17295.
- Darnis B, Blanchet MC, Buiron C, Crozet J, Duchamp C, Frering V, Gignoux B. Does the holmium laser have a place in the treatment of pilonidal cysts? (Pilolas study). Lasers Med Sci 2024 Nov 23;39(1):287.
- Dainius E, Garnyte J, Juskeviciute E, Parseliunas A, Latkauskas T, Burzinskiene G, Venskutonis D, Tamelis A. A Comparative Analysis of Pain Assessment Methods in the Initial Postoperative Phase Following Different Pilonidal Cyst Surgeries. Medicina (Kaunas) 2024 Oct 18;60(10).
- Haweizy RM. Surgeons' Experience and Practices in Managing the Pilonidal Sinus in the Kurdistan Region of Iraq. Cureus 2024 Jun;16(6):e62115.
- Lu W, Huang S, Ye H, Xiang S, Zeng X. The application of ERAS in pilonidal sinus: comparison of postoperative recovery between primary suture and Limberg flap procedure in a multicenter prospective randomized trial. Front Surg 2024;11:1120923.
- Kaneyuku S, Dohi T, Hammoudeh DS, Eura S, Kurokawa Y, Ogawa R. Understanding the Mechanical Forces on the Sacrum Can Help Optimize Flap-based Pilonidal Sinus Reconstruction. Plast Reconstr Surg Glob Open 2024 Jun;12(6):e5923.
- Dainius E, Vaiciute MK, Parseliunas A, Latkauskas T, Venskutonis D. Surgical treatment of pilonidal disease - Short-term follow up results of minimally invasive pit-picking surgery versus radical excision without suturing: A prospective randomised trial. Heliyon 2024 Jun 15;10(11):e31497.
- Łanocha M, Frątczak A, Tekielak A, Miziołek B, Bergler-Czop B. Misfortunes never come singly but in fours - follicular occlusion tetrad. Postepy Dermatol Alergol 2024 Apr;41(2):245-249.
- Tam A, Steen CJ, Chua J, Yap RJ. Pilonidal sinus: an overview of historical and current management modalities. Updates Surg 2024 Jun;76(3):803-810.
- Lee WG, Short C, Zhong A, Vojvodic V, Sundin A, Spurrier RG, Wang KS, Pelayo JC. Outcomes of pediatric pilonidal disease treatment: excision with off-midline flap reconstruction versus endoscopic pilonidal sinus treatment. Pediatr Surg Int 2024 Jan 31;40(1):46.
- Kansal R, Garg A, Arora B, Singh C, Malhotra K, Mehta M, Gupta A, Kishore H, Mondal H, Bawa A. Wide Local Excision of Complex or Infected Pilonidal Sinus Followed by Negative Pressure Wound Therapy: Does It Enhance Wound Healing?. Cureus 2023 Oct;15(10):e48049.
- Şahin AG, Alçı E. Use of the laser in the pilonidal sinus alone or in combination with phenol. Rev Assoc Med Bras (1992) 2023;69(12):e20230740.
- Huurman EA, Galema HA, de Raaff CAL, Wijnhoven BPL, Toorenvliet BR, Smeenk RM. Non-excisional techniques for the treatment of intergluteal pilonidal sinus disease: a systematic review. Tech Coloproctol 2023 Dec;27(12):1191-1200.
- Roncareggi S, Girardi K, Fioredda F, Pedace L, Arcuri L, Badolato R, Bonanomi S, Borlenghi E, Cirillo E, Coliva T, Consonni F, Conti F, Farruggia P, Gambineri E, Guerra F, Locatelli F, Mancuso G, Marzollo A, Masetti R, Micalizzi C, Onofrillo D, Piccini M, Pignata C, Raddi MG, Santini V, Vendemini F, Biondi A, Saettini F. A Nationwide Study of GATA2 Deficiency in Italy Reveals Novel Symptoms and Genotype-phenotype Association. J Clin Immunol 2023 Nov;43(8):2192-2207.
- Yang Y, Yang H, Han Y, Wang Z, Han C. Photo-crosslinking hydrogel for wound healing in a pilonidal sinus patient after open surgery. J Surg Case Rep 2023 May;2023(5):rjad152.
- Elvira Lopez J, Escuder Perez J, Sales Mallafre R, Feliu Villaro F, Caro Tarrago A, Espina Perez B, Ferreres Serafini J, Jorba Martin R. Randomised clinical trial to test the phenolization in sacrococcygeal pilonidal disease. Int Wound J 2023 Aug;20(6):2181-2189.
- Mahmoudvand H, Nadri S, Shekouhi R, Sohooli M, Seyed-Alagheband SA. Primary Closure of Pilonidal Sinus With Slide-Swing Skin Flap Compared With the Secondary Closure: A Single-Blinded Randomized Controlled Trial. Cureus 2022 Dec;14(12):e32880.
- Odlo M, Horn J, Xanthoulis A. Surgery for pilonidal sinus disease in Norway: training, attitudes and preferences-a survey among Norwegian surgeons. BMC Surg 2022 Dec 28;22(1):442.
- Mahjoubi MF, Ben-Latifa M, Karoui Y, Rezgui B, Ben-Belaid A, Essid N, Ben-Ali A, Ben-Moussa M. RADICAL VERSUS CONSERVATIVE METHODS IN ONE-STAGE PILONIDAL ABSCESS SURGERY: THE EXPERIENCE OF A TUNISIAN CENTER. Arq Bras Cir Dig 2022;35:e1713.
- Alkurt EG, Vardar YM, Tüzün İS. Comparison of Limberg Flap and Karydakis Flap Repair in Pilonidal Sinus Surgery: A Prospective Case-Control Study. Cureus 2022 Sep;14(9):e28933.
- Gurbanov A, Ergün E, Göllü G, Ateş U. Management of sacrococcygeal pilonidal sinus disease in children: A survey study in Turkey. Turk J Surg 2021 Sep;37(3):260-265.
- Mamaloudis I, Perivoliotis K, Zlatanos C, Baloyiannis I, Spyridakis M, Kouvata E, Samara AA, Christodoulidis G, Tepetes K. The role of alginate dressings in wound healing and quality of life after pilonidal sinus resection: A randomised controlled trial. Int Wound J 2022 Oct;19(6):1528-1538.
- Win M, Went TR, Ruo SW, Kannan A, Dominic JL, Sultan W, Kantamaneni K, Yanamala VL, Tara A, Elshaikh AO. A Systematic Review of Fibrin Glue as an Ideal Treatment for the Pilonidal Disease. Cureus 2021 Aug;13(8):e16831.
- Albabtain IT, Alkhaldi A, Aldosari L, Alsaadon L. Pilonidal sinus disease recurrence at a tertiary care center in Riyadh. Ann Saudi Med 2021 May-Jun;41(3):179-185.
- Oetzmann von Sochaczewski C, Gödeke J. Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany. Int J Colorectal Dis 2021 Oct;36(10):2135-2145.
- Metzger GA, Apfeld JC, Nishimura L, Lutz C, Deans KJ, Minneci PC. Principles in treating pediatric patients with pilonidal disease - An expert perspective. Ann Med Surg (Lond) 2021 Apr;64:102233.
- Kumar M, Clay WH, Lee MJ, Brown SR, Hind D. A mapping review of sacrococcygeal pilonidal sinus disease. Tech Coloproctol 2021 Jun;25(6):675-682.
- Esposito C, Mendoza-Sagaon M, Del Conte F, Cerulo M, Coppola V, Esposito G, Cortese G, Crocetto F, Montaruli E, Escolino M. Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in Children With Pilonidal Sinus Disease: Tips and Tricks and New Structurated Protocol. Front Pediatr 2020;8:345.
- Lamdark T, Vuille-Dit-Bille RN, Bielicki IN, Guglielmetti LC, Choudhury RA, Peters N, Doll D, Luedi MM, Adamina M. Treatment Strategies for Pilonidal Sinus Disease in Switzerland and Austria. Medicina (Kaunas) 2020 Jul 9;56(7).
- Pronk A, Kastelijns L, Smakman N, Furnee E. Sexual Function in Patients Suffering from Sacrococcygeal Pilonidal Sinus Disease. Cureus 2020 Mar 2;12(3):e7159.
- Riis PT, Saunte DM, Sigsgaard V, Villani AP, Guillem P, Pascual JC, Kappe NN, Vanlaerhoven AMJD, van der Zee HH, Prens EP, El-Domyati M, Abdel-Wahab H, Moftah N, Abdelghani R, Agut-Busquet E, Romaní J, Hlela C, van den Worm L, Bettoli V, Calamo G, Gürer MA, Beksaç B, Matusiak L, Glowaczewska A, Szepietowski JC, Emtestam L, Lapins J, Kottb HR, Fatani M, Weibel L, Theiler M, Delage-Toriel M, Lam TTH, Nassif A, Becherel PA, Dolenc-Voljc M, Doss N, Bouazzi D, Benhadou F, Del Marmol V, Jemec GBE. Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients. Arch Dermatol Res 2020 Dec;312(10):715-724.
- Häfner SJ. The body's integrated repair kit: Studying mesenchymal stem cells for better ligament repair. Biomed J 2019 Dec;42(6):365-370.
- Giuseppe F, Silvia DG, Patrizia R, Riccardo P, Antonio DS, Aldo RS, Angela I, Pietro M, Domenico M, Luciano T. Pilonidal sinus disease: Preliminary case-control study on heat-related wound dehiscence. Ann Med Surg (Lond) 2019 Dec;48:144-149.
- Dogan S, Cetin F, Gurleyik E. Inverse 'D' incision technique in treatment of pilonidal sinus disease; excision with minimal tissue loss, closure without tension and lateral location of the suture line. Ann Surg Treat Res 2019 Nov;97(5):261-265.
- Khafagy A, Al Haddad E, AlSabah S. The endoscopic treatment of pilonidal sinus disease: a short-term case-series study. Ann Saudi Med 2019 May-Jun;39(3):192-196.
- Oliveira AI, Barroso C, Osório A, Correia-Pinto J. Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center. Front Pediatr 2019;7:215.
- Gavriilidis P, Bota E. Limberg flap versus Karydakis flap for treating pilonidal sinus disease: a systematic review and meta-analysis. Can J Surg 2019 Apr 1;62(2):131-138.
- Liao LY, Li TS, Chen HC. Idea and innovation: Secure fixation between dermis and periosteum using perforator flap to prevent recurrence of pilonidal sinus disease. Int Wound J 2019 Jun;16(3):862-865.
- Giarratano G, Toscana C, Shalaby M, Buonomo O, Petrella G, Sileri P. Endoscopic Pilonidal Sinus Treatment: Long-Term Results of a Prospective Series. JSLS 2017 Jul-Sep;21(3).
- Tas S, Ozkan OF, Ocakli MM, Arslan E, Kiraz A, Karaayvaz M. MANAGEMENT OF FLAP DEHISCENCE AFTER LıMBERG PROCEDURE FOR RECURRENT PıLONıDAL DıSEASE BY NEGATıVE PRESSURE WOUND THERAPY (NPWT). Arq Bras Cir Dig 2017 Jan-Mar;30(1):73-74.
- Almajid FM, Alabdrabalnabi AA, Almulhim KA. The risk of recurrence of Pilonidal disease after surgical management. Saudi Med J 2017 Jan;38(1):70-74.
- Khodakaram K, Stark J, Höglund I, Andersson RE. Minimal Excision and Primary Suture is a Cost-Efficient Definitive Treatment for Pilonidal Disease with Low Morbidity: A Population-Based Interventional and a Cross-Sectional Cohort Study. World J Surg 2017 May;41(5):1295-1302.
- Jain Y, Javed MA, Singh S, Rout S, Joshi H, Rajaganeshan R. Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess. Ann R Coll Surg Engl 2017 Feb;99(2):134-136.
- Kanat BH, Sözen S. Disease that should be remembered: Sacrococcygeal pilonidal sinus disease and short history. World J Clin Cases 2015 Oct 16;3(10):876-9.
- Song HS, Kang HY. Sacrococcygeal nodule in a young male patient. Ann Dermatol 2014 Dec;26(6):771-3.
- Enshaei A, Motearefi S. Comparison of two surgical methods, primary closure and rotational flap, in patients with chronic pilonidal sinus. Glob J Health Sci 2014 Sep 18;6(7 Spec No):18-22.
- Karaman K, Ozturk S, Tugmen C, Kebapcı E, Dogan SM, Unver M, Olmez M, Aydin C. S-shaped wide excision with primary closure for extensive chronic pilonidal sinus disease. Case Rep Surg 2014;2014:451869.
- Enriquez-Navascues JM, Emparanza JI, Alkorta M, Placer C. Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus. Tech Coloproctol 2014 Oct;18(10):863-72.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists