Pilonidal Disease

  • Jeong Eun Lee


Pilonidal disease shows asymptomatic small pit or simple cyst in the center of buttocks about 5 cm above the anus, and pain and tenderness on pressure if it forms an abscess with cellulitis around the cyst. It is necessary to distinguish it from inflammatory diseases originating in the anus including anal fistula, hidradenitis suppurativa, and folliculitis through anal digital examination. The principle of treatment is to completely remove the sinus tract, and recurrence has to be prevented after the excised skin is all healed.


Pilonidal disease Bascom’s operation Advancement flap 


  1. 1.
    Karydakis GE. The etiology of pilonidal sinus. Hellenic Arm Forc Med Rev. 1975;7:411–6.Google Scholar
  2. 2.
    Hull TL, Wu J. Pilonidal disease. Surg Clin N Am. 2002;82:1169–85.CrossRefGoogle Scholar
  3. 3.
    Hanley PH. Acute pilonidal abscess. Surg Gynecol Obstet. 1980;150:9–11.PubMedGoogle Scholar
  4. 4.
    Nelson J, Billingham R. Pilonidal disease and hidradenitis suppurativa. In: Wolff BG, Fleshman JW, Beck DE, et al., editors. The ASCRS textbook of colon and rectal surgery. New York: Springer; 2007. p. 228–35.CrossRefGoogle Scholar
  5. 5.
    Lukish JR, Kindelan T, Marmon LM, et al. Laser epilation is a safe and effective therapy for teenagers with pilonidal disease. J Pediatr Surg. 2009;44:28205.Google Scholar
  6. 6.
    Conroy FJ, Kandamany N, Mahaffey PJ. Laser depilation and hygiene: preventing recurrent pilonidal sinus disease. J Plast Reconstr Aesthet Surg. 2008;61:1069–72.CrossRefGoogle Scholar
  7. 7.
    Schulze SM, Patel N, Hertzog D, et al. Treatment of pilonidal disease with laser epilation. Am Surg. 2006;72:534–7.PubMedGoogle Scholar
  8. 8.
    Jensen SL, Harling H. Prognosis after simple incision and dreainage for a first-episode acute pilonidal abscess. Br J Surg. 1988;75:60–1.CrossRefGoogle Scholar
  9. 9.
    Webb PM, Wysocki AP. Does pilonidal abscess heal quicker with off-midline incision and drainage ? Tech Coloproctol. 2011;15:179–83.CrossRefGoogle Scholar
  10. 10.
    Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980;87(5):567–72.PubMedGoogle Scholar
  11. 11.
    Oncel M, Kurt N, Kement M, et al. Excision and marsupialization versus sinus excision for the treatment of limited chronic pilonidal disease; a prospective randomized trial. Tech Coloproctol. 2002;6:165.CrossRefGoogle Scholar
  12. 12.
    Al-Hassan HK, Francis IM, Neglen P. Primary closure or secondary granulation after excision of pilonidal sinus? Acta Chir Scand. 1990;156:695–9.PubMedGoogle Scholar
  13. 13.
    Lord PH, Millar DM. Pilonidal sinus: a simple treatment. Br J Surg. 1965;52:298–300.CrossRefGoogle Scholar
  14. 14.
    Mosquera DA, Quayle JB. Bascom’s operation for pilonidal sinus. J R Soc Med. 1995;88(1):45–6.Google Scholar
  15. 15.
    Senapati A, Cripps NP, Thompson MR. Bascom’s operation in the day-surgical management of symptomatic pilonidal sinus. Br J Surg. 2000;87(8):1067–70.CrossRefGoogle Scholar
  16. 16.
    Mansoory A, Dickson D. Z-plasty for treatment of disease of the pilonidal sinus. Surg Gynecol Obstet. 1982;155(3):409–11.PubMedGoogle Scholar
  17. 17.
    Schoeller T, Wechselberger G, Otto A, Papp C. Definite surgical treatment of complicated recurrent pilonidal disease with a modified fasciocutaneous V-Y advancement flap. Surgery. 1997;121(3):258–63.CrossRefGoogle Scholar
  18. 18.
    Dýlek ON, Bekereciodlu M. Role of simple V-Y advancement flap in the treatment of complicated pilonidal sinus. Eur J Surg. 1998;164(12):961–4.CrossRefGoogle Scholar
  19. 19.
    Milito G, Cortese F, Casciani CU. Rhomboid flap procedure for pilonidal sinus: results from 67 cases. Int J Color Dis. 1998;13(3):113–5.CrossRefGoogle Scholar
  20. 20.
    Rosen W, Davidson JS. Gluteus maximus musculocutaneous flap for the treatment of recalcitrant pilonidal disease. Ann Plast Surg. 1996;37:293–7.CrossRefGoogle Scholar
  21. 21.
    Solla JA, Rothenberger DA. Chronic pilonidal disease. An assessment of 150 cases. Dis Colon Rectum. 1990;33:758–61.CrossRefGoogle Scholar
  22. 22.
    de Bree E, Zoetmulder FAN, Christodoulakis M, et al. Treatment of malignancy arising in pilonidal disease. Ann Surg Oncol. 2001;8:60–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Jeong Eun Lee
    • 1
  1. 1.Colorectal Division, Department of SurgeryHansol HospitalSeoulSouth Korea

Personalised recommendations