title: Pilonidal sinus disease. The conservative approach.
abstract: OBJECTIVE
  To examine the role of conservative, nonexcisional methods in the treatment of pilonidal sinus disease.
  
  
  METHODS
  Pilot nonrandomized cohort study and follow-up retrospective study.
  
  
  METHODS
  In the pilot study, all patients treated for pilonidal sinus disease consecutively over 3 years at an Army community hospital, and in the follow-up study within a closed federal population, all patients admitted with a diagnosis of pilonidal sinus disease over 17 years to an Army medical center.
  
  
  METHODS
  Conservative, nonexcisional therapy (meticulous hair control by natal cleft shaving, improved perineal hygiene, and limited lateral incision and drainage for abscess) with initial comparison to excisional procedures.
  
  
  METHODS
  Occupied-bed days for conservative vs excisional therapy during a 3-year pilot study and the number of admissions and procedures performed for pilonidal sinus disease at an institution dedicated to conservative treatment alone.
  
  
  RESULTS
  Complete healing over 83 occupied-bed days was demonstrated in 101 consecutive cases managed during 1 year with the conservative method, whereas slower healing over 4760 occupied-bed days was observed in 229 patients undergoing 240 operative procedures during the preceding 2 years. With application of conservative treatment over 17 years, only 23 excisional operations were performed.
  
  
  CONCLUSIONS
  Conservative therapy effectively controls pilonidal sinus disease in the nonoperative outpatient setting while promoting near-normal work status and is preferred over excisional operations.
authors.affiliation: Department of Surgery, Tripler Army Medical Center, Hawaii.
authors.forename: J H
authors.initials: JH
authors.lastname: Armstrong
authors.forename: P J
authors.initials: PJ
authors.lastname: Barcia
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome