Abstract
Purpose
The purpose of the study was to evaluate the outcome of pit-picking on adolescents
with pilonidal disease.
Methods
Patients presenting to a Pilonidal Clinic were managed by evacuation of any un-drained
collections, soaking, and as needed, hair removal. Once active inflammation resolved,
they underwent pit-picking under local anesthesia. Those with >3 pits underwent sequential pit-pickings 2 months apart. Hirsute patients also underwent
laser hair epilation. Pilonidal disease was stratified by severity. Patient symptoms
were collected prospectively and reviewed.
Results
Fifty-eight patients underwent at least one pit-picking from February 2016 to September
2017. There were 40 (69%) males with a mean age of 17.7 years (range 13–24). Thirty-seven
hirsute patients (64%) underwent a series of laser epilation treatments. Patients
required from 0 to 3 days of non-narcotic analgesia, and all returned promptly to
pre-procedure activities. Seven patients (12%) were lost to follow-up. Of the 51 patients
with follow-up data, 47 (92%) were symptom-free an average of 5.0 months (range 1–20)
post-procedure. Four patients (8%) had persistent intermittent drainage.
Conclusion
Pit-picking is a simple office procedure that may resolve pilonidal disease in many
adolescents. A longer follow-up interval is needed to determine the long-term recurrence
rate.
Type of study
Case Series.
Level of evidence
Level IV.
Key words
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Article info
Publication history
Published online: October 26, 2018
Accepted:
October 1,
2018
Received:
September 16,
2018
Footnotes
☆Author Contribution
☆Study conception and design: Hajar Delshad, David Mooney
☆Acquisition of data: Hajar Delshad, Michele Dawson, Susan Zotto, David Mooney
☆Analysis and interpretation of data: Michele Dawson, Patrice Melvin, David Mooney
☆Drafting of manuscript: Hajar Delshad
☆Critical revision of manuscript: David Mooney
☆☆Conflicts of interest: none
★How this paper will improve care: In a series of 58 adolescents who underwent pit-picking under local anesthesia in a specialized pilonidal clinic, >90% of the 51 patients with follow-up resolved with minimal morbidity. Pit-picking should be considered first-line pilonidal disease treatment.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
