Comparative Analysis of Surgical Techniques for Pilonidal Disease: Differentiating Between Recurrence and Persistent Wound Failure

Background: Pilonidal disease (PD) presents with a spectrum of clinical manifestations, ranging from symptomatic abscesses to troublesome hair-containing sinuses. Two common postoperative complications, recurrence and persistent wound failure, can be challenging to distinguish. We consider these complications as distinct entities that require different management approaches. This retrospective study aims to clarify our findings by comparing various surgical methods for PD.Methods: A total of 410 patients underwent three distinct surgical techniques. Various statistical analyses were performed to identify correlations between variables. The groups of recurrence and postoperative persistent wound failure were examined as separate surgical outcomes.Results: Over 80% of patients achieved complete healing from PD. Excision with marsupialization was performed in 38% of patients. Complete wound healing with no evidence of recurrence was observed in 331 patients (mean follow-up: 42.29 ± 10.41 weeks). Recurrence occurred in 24 patients (mean follow-up: 14.25 ± 6.05 weeks), while postoperative persistent wound failure occurred in 55 patients (mean follow-up: 7.49 ± 4.86 weeks). The SF-36 analysis revealed higher mental health and bodily pain scores in patients with complete wound healing compared to those with recurrent disease and persistent wound failure.Conclusion: Recurrence and postoperative persistent wound failure are distinct outcomes following the surgical treatment of PD. Differentiating between these postoperative outcomes is essential for accurately estimating recurrence rates and exploring targeted therapies to manage complications and reduce recurrence.