Trephination Versus Wide Excision for the Treatment of Pediatric Pilonidal Disease

Space: StayCurrentMD Author: James M. Prieto, Kyle D. Checchi, Karen M. Kling, Romeo C. Ignacio, Stephen W. Bickler, Nicholas C. Saenz, Timothy J. Fairbanks, Sneha I. Nicholson, David A. Lazar Published:

Author / Expert

James M. Prieto, Kyle D. Checchi, Karen M. Kling, Romeo C. Ignacio, Stephen W. Bickler, Nicholas C. Saenz, Timothy J. Fairbanks, Sneha I. Nicholson, David A. Lazar

Topic overview

Abstract

Background/Purpose

To evaluate outcomes of trephination compared to wide excision in children undergoing initial surgical treatment of pilonidal disease.

Methods

A retrospective review was conducted of patients undergoing initial pilonidal excision between September 2017 and September 2018. Operations were categorized as either trephination or wide excision via an open or closed-wound technique. Outcomes were evaluated and data analyzed by chi-squared and one-way ANOVA tests.

Results

One-hundred and five patients were identified, with a mean follow-up of 4.6 months. Trephination was performed in 57% of patients, and of the remaining patients undergoing wide excision, 62% of wounds were left open. There were no demographic differences among the three groups. Compared to both the open and closed techniques, trephination was associated with fewer wound complications (17% vs 29% vs 3%, respectively, p = 0.006), and postoperative visits (4.4 vs 2.4 vs 1.4, respectively, p 

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