This study evaluated various surgical procedures for treating pilonidal sinuses at a hospital in the UK between 2001-2004. It found that incision and drainage had the highest recurrence rate of 10%, while excision and closure had the lowest at 0.5%. Bascom's and Karydakis procedures resulted in no recurrences and the fastest return to work. The study concluded that excision and closure is best for uncomplicated cases, while Bascom's and Karydakis procedures have less recurrence and quicker recovery times.

1. Our Experience in treating Pilonidal Sinus at Royal Shrewsbury Hospital, a District General Hospital V Rao, R Hussein, R A Hurlow Department of Surgery, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, United Kingdom Aim : The aim of this study is to retrospectively evaluate the results of various procedures performed, to know effective way in treating Pilonidal sinuses and to find out recurrence rates for different surgical interventions. Methods : A retrospective audit of 168 patients undergoing treatment for acute and chronic symptoms of Pilonidal Sinuses between the period 2001-2004. Results: 70% were males; age range was between 16 to 76 years of age, with a mean age at presentation 29.4. 29% of cases were treated by Consultants, Registrars 45% and Senior House Officers performed operations in 21% of cases. Following are the surgical procedures performed; Incision and drainage was main surgical procedure performed for acute Pilonidal Abscesses – 41.7%, Excision and open operation performed in 32.7% of cases, Excision and closure- 18.4% of cases, Bascom`s procedure - 6.5% of cases and Karydakis in one case. Time for healing; Incision and drainage – 4-8 weeks Excision and open – 6-13 weeks Excision and closure – 4-6 weeks Bascom`s – 4-6 weeks Karydakis – 4 weeks Recurrences are the following for the operations; Incision and drainage – 10% Excision and open – 1% Excision and closure – 0.5% Bascom and Karydakis – No recurrence Annual Scientific Meeting, ASGBI, Edinburgh 2006 Discussion : Various methods are used as first time operations for pilonidal disease and recurrence rates vary from 3-43 percent. Surgical principle of wound lateralization was first described by Karydakis which avoids the consequence of a midline scar and the natal cleft becomes more shallow, which reduces the acute direction of sacral hairs in to the natal crevasse. Bascom`s cleft closure technique emphasizes the obliteration of the deep cleft, the creation of a healthy Skin -covered shallow furrow, the positioning of the suture line off the midline, and tissue tension relief between the coccyx and the skin. Conclusions : Incision and drainage operation has high recurrence rate. In excision and open there is a delay in wound healing. Excision and closure can be advocated in uncomplicated cases. Bascom`s and Karydakis procedures are associated with less recurrence and ensures early return to work . Follow-up in our study is not complete. References: 1. Modified Bascom`s Assymetric Closure Technique for Recurrent Pilonidal Disease Vol 46, No 9, Dis Colon Rectum, Sep 2003 2. Simple and Effective Surgical Treatment of Pilonidal Sinus Vol 43, No 5, Dis Colon Rectum, May 2005