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ACS Brief

Decisions on Definitive Pilonidal Sinus Surgery after Abscess Drainage Depend on Individual Patient Factors

February 25, 2025

de Kort J, Pronk AA, Vriens MR, et al. Long-term Follow-up of Sacrococcygeal Pilonidal Sinus Disease after Previous Abscess Drainage: A Retrospective Cohort Study. J Gastrointest Surg. 2025;29(2):101892.

 

Data describing the clinical course of patients who require incision and drainage of a pilonidal sinus abscess are lacking. This article reported a retrospective medical record review (n = 149) of patients who underwent incision and drainage of a pilonidal abscess and were followed out to a mean of 58.4 months.

The data analysis showed that 80.5% of patients were asymptomatic following drainage and secondary healing. Recurrence of symptoms requiring surgical treatment was diagnosed at a mean of 14 months follow up in 17.5% of this group.

Early definitive surgery (within 3 months of drainage) was performed because of persistent symptoms in 19.5% of patients. Limited excision with phenol application was the most common procedure performed. Four recurrences were diagnosed in the early surgery group.

Factors associated with the need for definitive surgery were male gender, history of smoking, and presence of sinus pits in the pilonidal cyst area.

The authors concluded that the decision to perform definitive pilonidal sinus surgery after abscess drainage should be based on symptoms and risk factors.

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