Outcomes of Silver Nitrate Application in the Treatment of Pilonidal Sinus Disease in Children

A BSTRACT Objective: This study aimed to retrospectively evaluate the clinical outcomes, recurrence rates, and safety profile of silver nitrate application in pediatric patients diagnosed with pilonidal sinus disease, with a minimum follow-up of 12 months. Materials and Methods: Pediatric patients diagnosed with pilonidal sinus disease and treated with silver nitrate between January 2024 and January 2025 were retrospectively reviewed. Demographic features, comorbidities, body mass index (BMI), number of sinus openings, treatment duration, number of applications, complications, and recurrence rates were recorded. A maximum of four weekly applications was planned. Absence of discharge or swelling at the end of treatment and sustained symptom-free status during follow-up were considered successful outcomes. This study was approved by the Institutional Ethics Committee (Approval No: 2024-KAEK-39), and informed consent was obtained from patient’s guardians. Clinical follow-up was conducted at 1, 3, 6, and 12 months posttreatment. Results: A total of 49 patients were included (20 males, 40.8%; 29 females, 59.2%) with a mean age of 15.5 years (range: 13–17). The average number of sinus openings was 2.04. Complete healing was achieved in 42 patients (85.7%), while seven patients (14.3%) required surgical intervention due to persistent discharge after four applications. The mean number of silver nitrate applications required for complete healing was 3.1. Mean BMI was 22.4, and no significant comorbidities were observed. No acute complications such as infection, bleeding, skin irritation, or seroma were observed, and a monitoring protocol for adverse events was followed. During the 12-month follow-up period, no recurrences were detected. Conclusion: Silver nitrate application represents a safe, effective, minimally invasive, and cost-efficient treatment modality for pilonidal sinus disease in children. The absence of recurrence in the 12-month follow-up suggests that silver nitrate may serve as a reliable first-line conservative management strategy before surgical intervention is considered.