Comparative outcomes of primary closure, rhomboid flap reconstruction, and open excision for pilonidal sinus disease: a retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Pilonidal sinus disease (PSD) is a common surgical condition with multiple operative options, each associated with different recurrence and recovery profiles. ObjectiveTo compare postoperative outcomes and recurrence rates among primary closure, rhomboid flap reconstruction, and open excision for PSD. MethodsThis retrospective cohort study included 300 patients with primary or recurrent PSD treated with primary closure (n = 100), rhomboid flap reconstruction (n = 100), or open excision (n = 100).Demographic characteristics, operative variables, postoperative pain, length of hospital stay, wound healing time, return to work, postoperative complications, and recurrence were analyzed.Continuous variables were compared using the Kruskal-Wallis test, while categorical variables were analyzed using the χ 2 test or Fisher exact test.Risk ratios (RRs) and risk differences with 95% CIs were calculated for comparative outcomes, and multivariable logistic regression was performed to identify independent factors associated with recurrence. ResultsBaseline demographic and clinical characteristics were comparable across treatment groups.Operative time and early postoperative pain did not differ significantly according to disease status within each surgical technique.Open excision was associated with a significantly lower overall recurrence risk than primary closure (RR, 0.29; 95% CI, 0.11-0.77),including among patients with primary disease.Rhomboid flap reconstruction demonstrated the shortest healing time (approximately 30 d), followed by primary closure (approximately 36 d), whereas open excision required substantially longer healing (>75 d)and delayed return to work.Postoperative complication rates were similar among techniques.Higher body mass index and positive family history were associated with increased recurrence.Conclusions Surgical technique was a major determinant of recurrence and recovery outcomes in PSD.Open excision achieved the lowest recurrence risk but required prolonged healing and delayed return to work.Rhomboid flap reconstruction provided faster recovery without a significant recurrence advantage over primary closure.These findings support individualized surgical decision-making based on recurrence risk, recovery expectations, and patient-related factors.
Source: Przegląd Lekarski
Authors: Abdullah AA. Abdullah, Mohamed TM. Sayed
Institutions: Luxor University, Sohag University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7222283806