Sacrococcygeal Pilonidal Sinus
Conditions
Keywords
Pilonidal sinus, Pediatric surgery, Recurrence, Wound healing, Surgical outcomes
Brief summary
Pilonidal sinus disease (PSD) in children is associated with significant morbidity and recurrence risk. Multiple surgical techniques are used, including excision with open healing, primary midline closure, off-midline closure, flap reconstruction, and minimally invasive approaches. However, high-quality comparative data in pediatric populations are limited, and adult data cannot be directly extrapolated. This single-center retrospective cohort study aims to compare the effectiveness of different surgical techniques used for curative treatment of PSD in children treated at CHU Angers between January 1, 2015 and March 31, 2025. The primary endpoint is surgical failure at 2 months, defined as absence of complete wound healing or early recurrence. Secondary outcomes include postoperative complications, time to healing, pain outcomes, length of hospital stay, and recurrence at 1 year. Results are expected to help optimize institutional management strategies and contribute to pediatric-specific evidence.
Detailed description
This is a single-center retrospective observational cohort study conducted in the Departments of Pediatric Surgery and Visceral Surgery at CHU Angers, France. All consecutive patients under 18 years of age who underwent surgical treatment for pilonidal sinus disease between January 1, 2015 and March 31, 2025 will be included. Surgical techniques analyzed include: * Wide excision with open healing * Wide excision with primary midline closure * Wide excision with primary midline closure and negative pressure wound therapy * Minimally invasive/endoscopic techniques The primary objective is to compare treatment effectiveness at 2 months postoperatively. Secondary objectives include comparison of complication rates, healing delay, postoperative pain, and recurrence at 1 year, as well as identification of predictive factors for recurrence. Data will be extracted from medical records and anonymized prior to statistical analysis.
Interventions
PROCEDURESurgical treatment for pilonidal sinus disease, including various techniques including excision with or without primary closure, or endoscopic techniques.
curative treatment of pilonidal sinus, consisting in a wide excision followed by open healing or direct closure of the wound +/- negative pressure therapy dressing. Alterantivelly, an endoscopic procedure to destroy the pilonidal sinus can be performed.
Sponsors
University Hospital, Angers
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Age \< 18 years at time of surgery * Surgical treatment for pilonidal sinus disease * Surgery performed between January 1, 2015 and March 31, 2025 * Managed at CHU Angers (Pediatric or Visceral Surgery departments) * ICD-10 diagnosis code L05.9 * CCAM procedure code QBFA007
Exclusion criteria
* Emergency incision and drainage of acute pilonidal abscess (CCAM QBPA001) * Initial surgical management performed at another institution * Refusal of participation (patient and/or legal guardians, if applicable) * Alternative diagnosis (anal abscess, gluteal abscess)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Failure rate | 2 months after surgery | Definition of failure: * Absence of complete wound healing at 2 months, OR * Clinical recurrence of pilonidal sinus within 2 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analgesic consumption for postoperative pain | Up to 30 days | morphine equivalent dose |
| Predictive factors for recurrence | Up to last follow-up | bivariate and multivariate analysis |
| Recurrence rate | Up to 1 year | Through study completion, average 6 month |
| Time to complete wound healing | Up to 1 year | time in months |
| Length of hospital stay | at hospital discharge | duration of hospital stay in days |
| Postoperative pain duration | Up to 30 days | — |
| Postoperative pain Intensity | Up to 30 days | — |
| Postoperative complications | Up to 1 year | * Early (\<30 days) and late complications * Graded according to Clavien-Madadi classification Through study completion, average 6 month |
Contacts
CONTACTFrançoise SCHMITT
PRINCIPAL_INVESTIGATORFrançoise SCHMITT
University Hospital of Angers
Outcome results
None listed