Pilonidal Disease
Everything in the library about pilonidal disease — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Management
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Update Course Rewind: Pilonidal Disease 2019
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Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Steven Lee talks us through the basics of minimally invasive excision for pilonidal disease. Mark your calend
podcast13:26 · Apr 2021
Evidence & Research
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Journal of Pediatric Surgery Article Review: July 2023, PAPS Issue
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We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!
This week we are discussing 3 articles from July 2023, PAPS issue, with editor Dr. Mary Brindle and authors Drs Jamie Schnuck and Bill Chiu
Ho
podcast10:46 · Jan 2024
Case-Based Learning
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Pilonidal Cyst Case Presentation: Update Course 2015
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During the 3rd Annual Stay Current in Pediatric Surgery Update Course in 2015, Dr. Ian Glenn leads this case based discussionon pilonidal cysts. Topics discussed include definitive treatment for pilonidal cyst disease, factors altering mana
video5:08 · Jan 2019
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Pilonidal Cyst Case Presentation: Update Course 2015
After 2-3 recurrences of pilonidal cyst, definitive surgery is indicated rather than repeat I&D.
opinion0:30 ↗
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).
clinical0:54 ↗
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.
clinical1:28 ↗
Physical exam findings including deep gluteal fold and heavy hair burden are high-risk factors for pilonidal disease recurrence.
clinical2:25 ↗
For severely infected pilonidal disease, open excision with wet-to-dry dressing changes or wound VAC is an option.
clinical2:50 ↗
The Karydakis flap is superior to excision only and comparable to the modified Limberg flap for pilonidal disease.
host_summary3:10 ↗
The modified elliptical rotation flap has short-term results comparable to Limberg and Karydakis flaps, though less data exists.
host_summary3:10 ↗
Post-operative management with prone positioning until wound healing is critical for preventing recurrence; pilonidal disease is fundamentally a wound healing problem.
opinion3:43 ↗
Plastic surgery consultation for flap reconstruction with strict prone post-operative positioning is used for multiply recurrent pilonidal disease.
clinical3:54 ↗
One patient reported laser hair removal as the most painful procedure they had experienced, completing only half a session and refusing further treatment.
clinical4:28 ↗
Laser hair removal for pilonidal disease is expensive and insurance reimbursement has not been successful.
clinical4:46 ↗
Journal of Pediatric Surgery Article Review: July 2023, PAPS Issue
The cryoanalgesia study compared patients from 2011 to 2021, with 29 patients receiving cryoanalgesia and 15 not receiving it.
host_summaryCecilia Gigena1:39 ↗
Patients who received cryoanalgesia had shorter hospital stays: 3.0 days versus 5.4 days for those without cryoanalgesia.
host_summaryCecilia Gigena1:48 ↗
Hospital costs were slightly lower (less than $1000 difference) in patients who received cryoanalgesia despite the expensive equipment.
host_summaryCecilia Gigena2:00 ↗
Cryoanalgesia was associated with a 70% decrease in complication rates, from approximately 33% down to 17%.
host_summaryMary Brindle2:31 ↗
The chest tube study included 130 lung resections performed between 2013 and 2022.
host_summaryMary Brindle3:48 ↗
Of the 130 procedures, 59 were lobectomies (group 1), 19 were diagnostic wedge resections (group 2), and 52 were excisional wedge resections (group 3).
host_summaryEm Gootee3:55 ↗
In lobectomy patients (group 1), 75% had no air leak and median chest tube duration was 2 days.
host_summaryJamie Schnuck4:12 ↗
In diagnostic wedge resection patients (group 2), nearly 90% had no air leak and median chest tube duration was 1 day.
host_summaryEm Gootee4:30 ↗
In excisional wedge resection patients (group 3), 80% had no air leak and median chest tube duration was 1 day.
host_summaryEm Gootee4:39 ↗
Most chest tubes were removed on the first day after surgery and a majority of patients did not have an air leak.
host_summaryJamie Schnuck4:48 ↗
The pilonidal disease study included 198 patients presenting between 2019 and 2022, with data prospectively gathered in a retrospective study design.
host_summaryMary Brindle6:37 ↗
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.
host_summaryCecilia Gigena6:51 ↗
To reach 75% hair reduction requires a mean of 4.8 to 6.8 laser ablation sessions depending on skin and hair characteristics.
host_summaryCecilia Gigena7:34 ↗
Dark hair and skin types 5-6 were associated with higher recurrence rates in pilonidal disease after laser hair reduction.
host_summaryCecilia Gigena7:47 ↗
The overall recurrence rate for pilonidal disease after laser hair reduction was 6%.
host_summaryCecilia Gigena7:47 ↗
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.
opinionMary Brindle8:12 ↗
All three articles were chosen as PAPS Award winners at the annual conference.
clinicalMary Brindle8:55 ↗
The three studies represent evolutionary (rather than revolutionary) advances important for day-to-day pediatric surgical care management.
opinionMary Brindle9:01 ↗
Update Course Rewind: Pilonidal Disease 2019
The patient presented with two previous abscess drainages (I&Ds) in the emergency department within the past 6 months
clinicalSteven Lee2:17 ↗
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