‘Pit-picking’ surgery forprimary pilonidal sinus: P171

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Aim:Most surgical treatments for pilonidal disease include total excision of sinus tracts, resulting in large wounds. Although the ‘pit-picking’ method was first described by Bascom 1980, it is not widely used.Method:The ‘pit-picking’procedure has been used in our centre since 2007. Only patients withprimary disease and small-volume pilonidal disease were selected for this method. The technique of ‘pit-picking’ involves removing allprimary pits in the midline by excising a skin border of < 1 mm. An 1 cm incision is made parallel to one side of the cleft opened the chronic abscess cavity. Total excision of the pilonidal sinus iss avoided. The operation was performed under local anesthesia in all cases but one.Results:Sixty-eight patients (57 males) underwent ‘pit-picking’ surgery. The mean age was 26.5 years (range, 14-43), the median duration of disease was 4 months (range, 0.1-216). Follow-up information was available for 55 patients, disease recurrence developed in eight (14%). One was cured by a second ‘pit-picking’procedure, all others were cured with a Karydakis flap.Conclusion:Most patients withprimary pilonidal disease can be treated successfully by use of the ‘pit-picking’procedure. Larger excisional surgery may be reserved for those who develop recurrence.

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