Outcomes and cost of medical and surgical treatments of pilonidal disease: A single institution's 10-year review

Autor: Kevin C. Janek, MD, Meaghan Kenfield, BA, Lisa M. Arkin, MD, Lily Stalter, MS, Giancarlo Tabaro, BA, Charles M. Leys, MD, Hau D. Le, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Surgery Open Science, Vol 9, Iss , Pp 41-45 (2022)
Druh dokumentu: article
ISSN: 2589-8450
DOI: 10.1016/j.sopen.2022.03.009
Popis: Background: Pilonidal disease is a chronic inflammatory skin disorder typically located in the gluteal cleft. Treatment varies from antibiotic therapy to extensive surgical resection and reconstruction; however, complications and recurrence are common. To understand risk factors, outcomes, and costs associated with various treatments, we performed a retrospective chart review of all patients treated for pilonidal disease at a single health care system from 2008 to 2018. Methods: Patients with an ICD diagnosis code associated with pilonidal disease were identified. Charts were reviewed for demographic, clinical, and cost information related to pilonidal disease encounters. Data were analyzed for risk of recurrence by Cox proportional hazards regression and economic burden by Wilcoxon signed-rank test. Results: During the study time frame, 513 patients were diagnosed with pilonidal disease. Primary treatment included 108 patients (21%) with wide excision, 167 (32%) with antibiotics alone, 79 (15%) with incision and drainage, and 109 (21%) with incision and drainage plus antibiotics. The rate of recurrence following antibiotic therapy, incision and drainage, or wide excision was 36.7%, 35.9%, and 21.3%, respectively. Sex, body mass index, obesity, or hidradenitis suppurativa was not associated with recurrence; however, smokers who underwent incision and drainage had a higher risk of recurrence (P
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