Unroofing Curettage for Pilonidal Disease

Study Overview
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Brief Summary
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This study aimed to investigate the outcomes of patients who underwent UC as the primary intervention for simple or complex SPD

Detailed Description
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Sacrococcygeal pilonidal disease (SPD) is a well-known chronic inflammatory condition that affects young adults; There are many treatment options available today, from simple non-surgical methods to extensive flap procedures. However, elaborate treatment strategies can turn this easily treatable disease into a long-term surgical ordeal, causing complications worse than the primary disease itself. While, UC is considered safe and effective for treating simple SPD, its suitability for treating complex disease is poor and controversial. To date, no studies have investigated the efficacy of UC specifically when treating complex SPD. This is the first study to identify and compare efficacy and outcomes after UC in patients classified into simple and complex SPD groups. This study was conducted at the Department of Surgery of the Diskapi Training and Research Hospital in Ankara, Turkey. The local ethics committee of the institution approved the study protocol (number 27/02, dated March 22, 2016), and written informed consent was obtained from all participants.

Official Title
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Unroofing Curettage for Treating Simple and Complex Sacrococcygeal Pilonidal Disease

Conditions
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Pilonidal Disease, Recurrence, Healing Wound

Intervention / Treatment
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* Procedure: unroofing curettage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive patients aged 18 years or older Exclusion Criteria: acute pilonidal abscess poorly controlled diabetes mellitus, immunosuppressive or coagulation disorders, pregnancy and/or lactation, other acute surgical diseases

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| unroofing curettage<br>Surgery was performed with the patient lying in the prone position under local anesthesia. Next, a local anesthetic agent comprising a solution of lidocaine (20 mg/mL) and adrenaline (0.0125 mg/mL) was diluted with distilled water in a 1:2 ratio and applied. The tract was identified by passing small artery forceps along its length and was then opened by cutting directly down onto the forceps. The sinus and all its tracts were completely unroofed, and the base was curetted to remove all necrotic content, hair, and granulation tissue using a dry gauze. The fibrotic back wall was left as intact as possible to avoid delayed healing. | Procedure: unroofing curettage<br>* Surgery was performed with the patient lying in the prone position under local anesthesia. The tract was identified by passing small artery forceps along its length and was then opened by cutting directly down onto the forceps. The sinus and all its tracts were completely unroofed, and the base was curetted to remove all necrotic content, hair, and granulation tissue using a dry gauze. The fibrotic back wall was left as intact as possible to avoid delayed healing. Hemostasis was achieved using diathermy with no drainage needed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recurrence | After healing was complete, any new sinus orifice or discharge from the wound was defined as disease recurrence. | 15 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| complete healing time | time after surgery until the wound is completely epithelialized | 15 days | 
| VAS pain score | Visual analog scale for pain | 15 days | 
| time to return to daily activities | time after surgery until the to return to daily activities | 15 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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complex pilonidal disease, unroofing curettage, recurrence, Lay open technique