Short-Term and Long-Term Outcomes of the Cleft Lift Procedure in the Management of Nonacute Pilonidal Disorders

• Published in: Diseases of the colon & rectum Vol. 51; no. 7; pp. 1100 - 1106
• Main Authors: Abdelrazeq, Ayman S., Rahman, Mujeeb, Botterill, Ian D., Alexander, David J.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.07.2008; The ASCRS; Springer; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adolescent; Adult; Biological and medical sciences; Chronic Disease; Colorectal Surgery; Dermatology; Digestive System Surgical Procedures - methods; Female; Follow-Up Studies; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Contribution; Patient Satisfaction; Pilonidal Sinus - surgery; Prospective Studies; Surgery; Surgical Flaps; Surgical Oncology; Surveys and Questionnaires; Time Factors; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions; Wound Healing; Cleft lift; Pilonidal disease; Bascom’s procedure; Cleft closure; Pilonidal sinus; Short term; Skin disease; Prognosis; Stomatology; Pilonidal cyst; Congenital cleft; Congenital disease; Long term; Bascom's procedure; Malformation; Gastroenterology; Benign neoplasm
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/s10350-008-9262-z

Purpose We report the results of the cleft lift procedure in the management of nonacute pilonidal sinus disorders. Methods Seventy consecutive patients who underwent a cleft lift for nonacute pilonidal sinus were evaluated prospectively. Responses to a postal questionnaire were analyzed for long-term outcome. Results All patients who fulfilled the criteria for day-case were operated on as such. Sixty-six patients achieved complete wound healing within six weeks. Delayed wound healing occurred in three patients and nonhealing occurred in one. Fourteen patients had one or more complications: wound breakdown, superficial (n = 7) and deep (n = 1); wound infection (n = 5); wound seroma (n = 4); and early recurrence (n = 1). The median time off work and to return to normal activities was two and four weeks, respectively (range, 0.5–12). Forty-seven patients completed the questionnaire at a median follow-up of 24 months: five patients reported minimal tenderness in the sacral region; none reported recurrence of pilonidal symptoms; and all were satisfied. Conclusions The cleft lift procedure is easy to perform as a day-case procedure. It is associated with high rates of primary healing, durable low recurrence rates, and early functional recovery. This technique may be the procedure of choice in the surgical management of nonacute pilonidal disorders.