Pilonidal sinus disease recurrence at a tertiary care center in Riyadh.

BACKGROUND

Pilonidal sinus disease (PSD) is a chronic inflammatory disease of the sacrococcygeal area. Pilonidal sinus recurrence is a matter of concern to both patients and healthcare providers.

OBJECTIVES

Estimate the rate of PSD recurrence in our center and identify any risk factors contributing to disease recurrence.

DESIGN

Retrospective.

SETTING

Tertiary care center in Riyadh.

PATIENTS AND METHODS

All patients who underwent surgery for primary or recurrent pilonidal sinus between 1 January 2016 to 30 June 2019 were included to allow for at least 1-year of follow-up at the time of data collection.

MAIN OUTCOME MEASURE

Recurrence rate of PSD and risk factors for recurrence.

SAMPLE SIZE AND CHARACTERISTICS

369 patients: 329 males (89.2%) and 40 (10.8%) females. Median (interquartile range) age was 21 (18-26) years.

RESULTS

Of the 369 included patients, recurrence was identified in 84 (22.8%) cases [95% confidence interval (CI) 18.6-27.4], and the mean timing of recurrence was 1.8 (1.6) years after the primary surgery. In a multivariate logistic regression analysis, increased age and post-operative seroma fluid discharge were independent risk factors for recurrence. In contrast, preoperative antibiotic prophylaxis and postoperative hair removal were effective in reducing recurrence. Type of surgery closure had no effect on recurrence, yet primary closure was associated with early onset of recurrence compared to secondary closure (=.02).

CONCLUSION

Our findings on the factors associated with recurrence of PSD are consistent with many reports in the literature. Reported prevalence estimates vary widely.

LIMITATION

Single center, small sample size, retrospective.

CONFLICT OF INTEREST

None.