Unroofing and curettage for the treatment of acute and chronic pilonidal disease.
BACKGROUND
Various surgical techniques are available in the management of pilonidal sinus, but controversy concerning the optimal surgical approach persists. The present study analyzes the outcome of unroofing and curettage as the primary intervention for acute and chronic pilonidal disease.


METHODS
A total of 297 consecutive patients presenting with chronic disease, acute abscess, or recurrent disease were treated with unroofing and curettage. The wound was left open to heal by secondary intention. Hospitalization, time required to resume daily activities and return to work, healing time, and recurrence rates were recorded.


RESULTS
All patients were discharged within the first 24 h after operation. The median period before returning to work was 3.2 +/- 1.2 days, and the mean time for wound healing was 5.4 +/- 1.1 weeks. Six patients were readmitted with recurrence of the disease within the first six postoperative months. All recurrences were in patients who did not follow the wound care advice and who did not come to regular weekly appointments. Patients with recurrence underwent repeat surgery by the same technique with good results.


CONCLUSIONS
Unroofing and curettage for pilonidal sinus disease is an easy and effective technique. The vast majority of the patients, including those with abscess as well as those with chronic disease, will heal with this simple procedure, after which even recurrences can be managed successfully with the same procedure. Relying on these results, we advocate unroofing and curettage as the procedure of choice in the management of pilonidal disease.
Kepenekci
Ilknur
I
Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey. ilknurkpn@yahoo.com
Demirkan
Arda
A
Celasin
Haydar
H
Gecim
Ibrahim Ethem
IE
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003475:Curettage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010864:Pilonidal Sinus / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome; D014945:Wound Healing