Clinical presentation and management outcome of pilonidal sinus disease

Background: Pilonidal sinus disease (PSD) is a relatively common and socially disabling healthcare issue among young adult males whose occupational work involves prolonged sitting. It frequently a ects the natal cleft region. The current study was undertaken to determine the epidemiologic pro le of the PSD in our patients, to document the cure rate at 12 weeks, and any recurrence at a 2-year follow-up following radical surgical excision of the pathology. Methods: This descriptive case series was undertaken at the National Institute of Rehabilitation Medicine (NIRM), Islamabad, for six years. The study included all patients who presented with the PSD and underwent radical surgical excision at the hospital. Patients who received some surgical treatment elsewhere were excluded. The primary outcome measure was the cure of the disease at 12 weeks, whereas the secondary outcome measure was the recurrence of the disease for 2 years of follow-up. Results: There were 31 patients, including 24 (77.41%) males and 7 (22.58%) females. The mean age was 27.35±6.96 years. The sites affected included the natal cleft regions (n=24; 77.41%), umbilicus (n=6; 19.35%), and interdigital regions (n=1; 3.22%). Most patients (n=22; 70.96%) were drivers by occupation. The commonest clinical presentation was with draining sinuses found among all the patients. The surgical procedures performed included radical excision and reconstruction with Limberg aps (n=21; 67.74%), radical excision and direct closure of the defect (n=8; 25.80%), and omphalectomy (n=2; 6.45%). Recurrence of the disease was observed in one (3.22%) patient at the two-year follow-up. Conclusions: PSD was found most frequently among young adult males. The majority of them were professional truck and lorry drivers. Natal cleft was the most welcome site of the disease. Limberg ap was the workhorse for managing the disease involving the natal cleft region. With radical surgical excision and reconstruction with Limberg ap, a recurrence rate of 3.22% was observed at two years of follow-up.