Late results of surgery for pilonidal disease with an assessment of the cosmetic effect after various options for wound closure

AIM: to improve late results of pilonidal disease treatment.PATIENTS AND METHODS: a multicenter retrospective cohort study included patients with pilonidal disease using the original new method — the main group (n = 31) and patients with Karidakis method as controls (n = 70). The recurrence rate was estimated. Six months after surgery, ultrasound, the Vancouver Scale and the SF-36 questionnaire assessed the postoperative scar, cosmetic result and quality of life.RESULTS: the cosmetic effect of the postoperative scar was evaluated and significant differences between groups were obtained. According to the Vancouver Scale, 12 (41.4%) patients of the main group and 11 (16.9%) patients from the control group had a normal color of the postoperative scar (0 points) (p = 0.02). When assessing the pigmentation of the scar, it was found that normal pigmentation (0 points) was found in 8 (28.0%) patients of the main group, and in the control group this indicator was only 5 (8.0%) cases (p = 0.02). The pressure-resistant scar density (2 points) was 17 (59.0%) patients in the main group and 22 (34.0%) patients in the control group (p = 0.04). The scar width in the group using the new method was 1–2 mm (1 point) in 20 cases (69%), whereas in the control group, a similar scar width was recorded in 18 (28.0%) patients (p < 0.001). When evaluating the results of ultrasound of the soft tissue infiltration zone (p = 0.26) and the volume of infiltration (p = 0.36), as well as assessing the quality of life, no significant differences were found. There were no significant differences in the recurrence rate: in the main group it was 2 (6.45%), in the comparison group — 5 (7.14%) cases (p = 0.77).CONCLUSIONS: a new original method for pilonidal disease in comparison with the Karydakis method provides a better cosmetic result