Prognosis

The recurrence rate of pilonidal sinuses after surgery is purported to be as high as 50% with incision and drainage. Procedures that leave a midline scar are the most susceptible to further hair penetration.

Recurrence rates with other techniques are:

Phenol injection: 8% to 9%

Fibrin injection: 5% to 29%

Excision with healing by secondary intention: 2% to 42%

Karydakis flap: 0% to 6%

Rhomboid (Limberg) flap: 0% to 24%

Bascom cleft-lift: 0% to 11%

Sinusectomy (trephination/Gips procedure): 0% to 16%

Endoscopic pilonidal sinus treatment: 0% to 15%

Reference

1. Gil LA, Deans KJ, Minneci PC. Management of pilonidal disease: a review. JAMA Surg. 2023 Aug 1;158(8):875-83.