# Pilonidal Disease — GCMD Library living collection

Everything in the library about pilonidal disease — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 31 cited statements

## Episodes
### Surgical Management
- [Update Course Rewind: Pilonidal Disease 2019](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925) — podcast · 13:26 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925.md)

### Evidence & Research
- [Journal of Pediatric Surgery Article Review: July 2023, PAPS Issue](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900) — podcast · 10:46 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900.md)

### Case-Based Learning
- [Pilonidal Cyst Case Presentation: Update Course 2015](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982) — video · 5:08 · [machine version](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982.md)

## Chapters
- [0:01](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=1) Case presentation and timing of definitive surgery (Ep 1)
- [0:54](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=54) Bascom pit-picking technique (Ep 1)
- [2:19](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=139) Risk factors affecting management (Ep 1)
- [2:43](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=163) Surgical options for definitive management (Ep 1)
- [3:34](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=214) Management of recurrent disease (Ep 1)
- [4:20](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=260) Laser hair removal as adjunct (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=0) Introduction and Case Presentation (Ep 2)
- [2:17](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=137) Rationale for GIPS Procedure Adoption (Ep 2)
- [4:53](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=293) GIPS Technique and Key Principles (Ep 2)
- [7:00](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=420) Adjunctive Techniques and Wound Management (Ep 2)
- [9:46](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=586) Antibiotic Use and Acute Abscess Management (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=0) Introduction and Episode Overview (Ep 3)
- [1:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=68) Cryoanalgesia Impact on Pectus Excavatum Repair Outcomes (Ep 3)
- [3:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=200) Chest Tube Management After Pediatric Lung Resection (Ep 3)
- [6:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=368) Laser Hair Reduction for Pilonidal Disease Recurrence Prevention (Ep 3)
- [8:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=525) Summary and Closing Remarks (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "After 2-3 recurrences of pilonidal cyst, definitive surgery is indicated rather than repeat I&D." (opinion) [Ep 1 · 0:30](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=30)
- "The Bascom technique involves excising 1-millimeter pits at skin level under local anesthesia, allowing secondary healing, with 70% not recurring by their data (though no control group exists)." (clinical) [Ep 1 · 0:54](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=54)
- "For large draining sinuses or recurrence after pit excision, formal OR excision of the entire affected area with off-midline layered closure and drain placement is performed." (clinical) [Ep 1 · 1:28](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=88)
- "Physical exam findings including deep gluteal fold and heavy hair burden are high-risk factors for pilonidal disease recurrence." (clinical) [Ep 1 · 2:25](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=145)
- "For severely infected pilonidal disease, open excision with wet-to-dry dressing changes or wound VAC is an option." (clinical) [Ep 1 · 2:50](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=170)
- "The Karydakis flap is superior to excision only and comparable to the modified Limberg flap for pilonidal disease." (host_summary) [Ep 1 · 3:10](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=190)
- "The modified elliptical rotation flap has short-term results comparable to Limberg and Karydakis flaps, though less data exists." (host_summary) [Ep 1 · 3:10](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=190)
- "Post-operative management with prone positioning until wound healing is critical for preventing recurrence; pilonidal disease is fundamentally a wound healing problem." (opinion) [Ep 1 · 3:43](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=223)
- "Plastic surgery consultation for flap reconstruction with strict prone post-operative positioning is used for multiply recurrent pilonidal disease." (clinical) [Ep 1 · 3:54](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=234)
- "One patient reported laser hair removal as the most painful procedure they had experienced, completing only half a session and refusing further treatment." (clinical) [Ep 1 · 4:28](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=268)
- "Laser hair removal for pilonidal disease is expensive and insurance reimbursement has not been successful." (clinical) [Ep 1 · 4:46](https://library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=286)
- "The cryoanalgesia study compared patients from 2011 to 2021, with 29 patients receiving cryoanalgesia and 15 not receiving it." — Cecilia Gigena (host_summary) [Ep 3 · 1:39](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=99)
- "Patients who received cryoanalgesia had shorter hospital stays: 3.0 days versus 5.4 days for those without cryoanalgesia." — Cecilia Gigena (host_summary) [Ep 3 · 1:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=108)
- "Hospital costs were slightly lower (less than $1000 difference) in patients who received cryoanalgesia despite the expensive equipment." — Cecilia Gigena (host_summary) [Ep 3 · 2:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=120)
- "Cryoanalgesia was associated with a 70% decrease in complication rates, from approximately 33% down to 17%." — Mary Brindle (host_summary) [Ep 3 · 2:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=151)
- "The chest tube study included 130 lung resections performed between 2013 and 2022." — Mary Brindle (host_summary) [Ep 3 · 3:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=228)
- "Of the 130 procedures, 59 were lobectomies (group 1), 19 were diagnostic wedge resections (group 2), and 52 were excisional wedge resections (group 3)." — Em Gootee (host_summary) [Ep 3 · 3:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=235)
- "In lobectomy patients (group 1), 75% had no air leak and median chest tube duration was 2 days." — Jamie Schnuck (host_summary) [Ep 3 · 4:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=252)
- "In diagnostic wedge resection patients (group 2), nearly 90% had no air leak and median chest tube duration was 1 day." — Em Gootee (host_summary) [Ep 3 · 4:30](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=270)
- "In excisional wedge resection patients (group 3), 80% had no air leak and median chest tube duration was 1 day." — Em Gootee (host_summary) [Ep 3 · 4:39](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=279)
- "Most chest tubes were removed on the first day after surgery and a majority of patients did not have an air leak." — Jamie Schnuck (host_summary) [Ep 3 · 4:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=288)
- "The pilonidal disease study included 198 patients presenting between 2019 and 2022, with data prospectively gathered in a retrospective study design." — Mary Brindle (host_summary) [Ep 3 · 6:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=397)
- "The pilonidal disease cohort included 21 patients with skin types 1-2, 156 with skin types 3-4, and 21 with skin types 5-6, with approximately 151 having dark colored hair." — Cecilia Gigena (host_summary) [Ep 3 · 6:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=411)
- "To reach 75% hair reduction requires a mean of 4.8 to 6.8 laser ablation sessions depending on skin and hair characteristics." — Cecilia Gigena (host_summary) [Ep 3 · 7:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=454)
- "Dark hair and skin types 5-6 were associated with higher recurrence rates in pilonidal disease after laser hair reduction." — Cecilia Gigena (host_summary) [Ep 3 · 7:47](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=467)
- "The overall recurrence rate for pilonidal disease after laser hair reduction was 6%." — Cecilia Gigena (host_summary) [Ep 3 · 7:47](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=467)
- "Insurance coverage for laser hair reduction varies, with some agencies covering it while in Canada advocacy to health systems is needed, making effectiveness data important for coverage decisions." — Mary Brindle (opinion) [Ep 3 · 8:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=492)
- "All three articles were chosen as PAPS Award winners at the annual conference." — Mary Brindle (clinical) [Ep 3 · 8:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=535)
- "The three studies represent evolutionary (rather than revolutionary) advances important for day-to-day pediatric surgical care management." — Mary Brindle (opinion) [Ep 3 · 9:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=541)
- "The patient presented with two previous abscess drainages (I&Ds) in the emergency department within the past 6 months" — Steven Lee (clinical) [Ep 2 · 2:17](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=137)
- "At UCLA, the institution was transitioning from unroofing and marsupialization to minimal pit excision for pilonidal disease management as of 2019" — Steven Lee (clinical) [Ep 2 · 2:45](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=165)
- "The GIPS procedure was the most rapidly adopted technique ever presented at the update course" — Todd Ponsky (opinion) [Ep 2 · 3:24](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=204)
- "Doctor Lee sometimes performs GIPS procedures in his office" — Steven Lee (host_summary) [Ep 2 · 3:54](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=234)
- "GIPS procedures can be done in the clinic or on an outpatient basis" — Steven Lee (clinical) [Ep 2 · 3:54](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=234)
- "GIPS procedure shows improved outcomes with respect to healing times, recovery times, and decreased need for additional operations and recurrence rates compared to traditional open excisions" — Steven Lee (host_summary) [Ep 2 · 4:34](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=274)
- "The GIPS technique uses punch biopsies (trephines) to excise pits, followed by tract cleaning with a mosquito clamp" — Todd Ponsky (clinical) [Ep 2 · 4:57](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=297)
- "Some surgeons use sinus endoscopy (cystoscope) after pit excision to identify and remove remaining hair and granulation tissue from the cavity" — Meera Kotagal (clinical) [Ep 2 · 5:31](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=331)
- "The key principle is that excising all pits allows access to the cavity for thorough cleaning; leaving material behind leads to recurrence" — Steven Lee (clinical) [Ep 2 · 6:30](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=390)
- "For recurrences, minimally invasive tactics can be repeated, including pit picking technique where hairs are plucked out" — Steven Lee (host_summary) [Ep 2 · 6:30](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=390)
- "Doctor Lee occasionally uses hydrogen peroxide to help clean out the tract but does not use sclerosing agents" — Steven Lee (clinical) [Ep 2 · 7:07](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=427)
- "Aggressive scraping of granulation tissue using Cottes and gauze is performed after hair removal" — Steven Lee (clinical) [Ep 2 · 7:46](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=466)
- "Traditional unroofing and marsupialization required roughly 4 to 6 weeks for complete healing" — Steven Lee (clinical) [Ep 2 · 8:17](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- "Weekly hair shaving is recommended during healing with one-week follow-up visits" — Steven Lee (clinical) [Ep 2 · 8:17](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- "If incisions close too early, silver nitrate can be used in clinic to keep the incisions open" — Steven Lee (clinical) [Ep 2 · 8:17](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- "The Midwest Pediatric Surgery Consortium is conducting a multi-center cohort study comparing largely invasive to minimally invasive procedures for pilonidal disease with standardized GIPS and medical management recommendations" — Alex Cassar (clinical) [Ep 2 · 9:14](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=554)
- "Doctor Lee does not use antibiotics for GIPS procedures unless there is an abscess, because wounds are left open to drain" — Steven Lee (clinical) [Ep 2 · 10:05](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=605)
- "No perioperative antibiotics are needed for GIPS procedures" — Steven Lee (clinical) [Ep 2 · 10:05](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=605)
- "Doctor Byerly performs GIPS even in the presence of acute abscess, using a vessel loop technique for the abscess cavity to allow better drainage" — Elizabeth Byerly (clinical) [Ep 2 · 10:42](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=642)
- "For patients with significant cellulitis or systemic illness, formal abscess drainage is preferred over immediate GIPS" — Elizabeth Byerly (clinical) [Ep 2 · 10:42](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=642)
- "Doctor Lee advocates draining abscesses off midline so that when the tract forms, it will be off midline" — Steven Lee (clinical) [Ep 2 · 11:09](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=669)
- "For emergency department drainage with significant inflammation and infection, adequate clean-out often cannot be achieved, so simple abscess drainage is recommended" — Steven Lee (clinical) [Ep 2 · 11:09](https://library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=669)

## Changelog
- Sep 17: 3 items added automatically

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