Objective:

To propose an algorithm for managing pilonidal disease based on extensive outcome data collected over three decades.

Approach:

Key Findings:

• The mean age of patients was 28 years, with a mean symptom duration of 3.6 years.
• 70.5% of patients had Type 1 or Type 2 disease, primarily treated with non-excisional methods.
• 29.5% of patients had Type 3 or Type 4 disease, mostly treated with cleft closure surgery.

Interpretation:

Limitations:

• The study was retrospective and based on data from two hospitals, which may limit generalizability.
• Some patients lacked adequate information for classification.

Conclusion:

The proposed algorithm aims to improve treatment outcomes for pilonidal disease by matching surgical techniques to disease severity.

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