title: Five-year Follow-up and Recurrence Rates Following Surgery for Acute and Chronic Pilonidal Disease: A Survey of 421 Cases.
abstract: OBJECTIVE
  The aim of the present study was to investigate the outcomes of different treatment options for acute and chronic pilonidal disease in a single large cohort of patients.
  
  
  METHODS
  Four hundred and twenty-one consecutive patients (171 with chronic disease and 250 with acute abscess formation) who underwent surgery between 2003 and 2012 were included in the present study. Primary outcomes included symptomatic recurrence, time to wound healing, and time off from work. The median follow-up was 5.3 years.
  
  
  RESULTS
  In patients with acute abscess formation, the relapse rate was significantly higher (P = 0.0001) if they were treated with abscess excision (38.9%) compared with a wide local excision (13.3%). Time to relapse was significantly longer (P = 0.0205) in patients treated with wide local excision (median 7 vs 3 months), whereas time to wound healing and the days off from work were similar among groups. In chronic disease, the relapse rate was similar in patients treated with wide local excision followed by secondary wound healing (11.3%) when compared with patients treated with limited excision (27.6%) or wide excision with primary wound closure (26.8%). The time to wound healing was shortest in patients with primary wound closure following wide local excision, and the time off from work was not significantly different between groups.
  
  
  CONCLUSIONS
  Wide local excision with secondary wound healing seems to be the favorable operation method for acute and chronic pilonidal disease.
authors.affiliation: Department of Surgery, Hospital Bülach, Zürich, Switzerland.
authors.forename: Gabriela Tonia
authors.initials: GT
authors.lastname: Fahrni
authors.affiliation: Department of Surgery, Hospital Bülach, Zürich, Switzerland and Department of Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland.
authors.forename: Raphael Nicolas
authors.initials: RN
authors.lastname: Vuille-Dit-Bille
authors.affiliation: University of Zurich, Zürich, Switzerland.
authors.forename: Svenja
authors.initials: S
authors.lastname: Leu
authors.affiliation: Department of Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Meuli
authors.affiliation: Department of Surgery, Clinic for Visceral and Thoracic Surgery, Hospital Winterthur, Switzerland.
authors.forename: Ralph Fabian
authors.initials: RF
authors.lastname: Staerkle
authors.affiliation: Mathematic faculty, Cantonal School of Wil, St. Gallen, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Fink
authors.affiliation: Department of Surgery, Hospital Bülach, Zürich, Switzerland.
authors.forename: Selim
authors.initials: S
authors.lastname: Dinçler
authors.affiliation: Department of Surgery, Hospital Bülach, Zürich, Switzerland.
authors.forename: Brigitte Susanne
authors.initials: BS
authors.lastname: Muff
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D010864:Pilonidal Sinus / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing