ThP6.19 - Surgical Management in Sacrococcygeal Pilonidal Sinus Disease Depending on The Suggested Staging System

Abstract Background The ideal management of the PNS has not been established yet. However; The optimal method should cover rapid recovery and return to normal daily activities, low recurrence rate, be technically applicable with reasonable cost. Aim to evaluate outcomes with the use of a stage-based treatment approach. Method A cohort prospective analytical study was conducted at Basrah Teaching Hospital-Iraq, a total of 71 patients were operated based on the proposed staging system in the period between December 2018 to April 2022, the staging system (Stage I–IV) was defined by using the morphological extent. the collected data includes demographic, perioperative data, short and long-term outcomes. Results Stage IV had the highest abscess drainage, drain insertion, and hospital stay. Concerning the short and long-term complications, the following frequencies were observed: Collection (9.85%), Infection (8.45%), and Dehiscence (4.22%), the collection and dehiscence were highest among stage R while the lowest rate of collection and infection was among stage III cases (6.67%, 6.67%) accordingly. Primary healing was recorded (91.5%) among the overall included patients with the higher rates of stage II-a (100.0%) with the lowest being among stage R (71.4%). Stage IV patients experienced the longest time for functional recovery and wound healing (14.25± 7.13, 13.25± 7.27) accordingly. The Recurrence rate was (2.81%) commonly observed among stage II-a (16.67%). Conclusion PNS is a recognizable condition in our locality and presents in different stages, thus this proposed staging system categorizes its extent and is a valuable tool in tailoring surgical approaches to each stage, Furthermore, it provides a common language for the surgeon to communicate about the disease.