Pilonidal Disease: Surgical Management and Treatment Options | Dr. Daniel Gould

Dr. Daniel Gould co-authored this review published in Annals of Plastic Surgery, examining both established and contemporary approaches to the surgical management of pilonidal disease.

Pilonidal disease is a chronic inflammatory condition that most commonly develops near the cleft between the buttocks. It can lead to recurring infections, abscesses, drainage, and discomfort, with recurrence remaining an important challenge following treatment.

The authors reviewed the existing surgical literature to compare techniques, outcomes, complications, healing times, and recurrence rates. Their analysis included approaches ranging from open excision and healing to primary closure and more advanced flap-based reconstruction.

The review found that open healing can provide reliable outcomes but may require a prolonged healing period. Off-midline and asymmetric closure techniques were associated with shorter healing times and lower recurrence rates compared with traditional midline closure. (PubMed)

Dr. Gould and his co-authors also examined how the extent and location of disease can influence treatment selection. More complex or recurrent cases may require reconstructive techniques that reposition tissue and flatten the natal cleft, helping address anatomical factors that can contribute to recurrence.

The review provides surgeons with an evidence-based overview of available treatment strategies, emphasizing that surgical management should be tailored to the individual presentation while considering wound healing, recurrence risk, and long-term outcomes.