Effectiveness of Different Surgical Techniques for Curative Treatment of Pilonidal Sinus Disease in the Pediatric Population (PiloPedia)
Effectiveness of Different Surgical Techniques for Curative Treatment of Pilonidal Sinus Disease in the Pediatric Population: A 10-Year Single-Center Retrospective Comparative Cohort Study
Pilonidal sinus disease (PSD) in children is associated with significant morbidity and recurrence risk. Multiple surgical techniques are used, including excision with open healing, primary midline closure, off-midline closure, flap reconstruction, and minimally invasive approaches. However, high-quality comparative data in pediatric populations are limited, and adult data cannot be directly extrapolated.
This single-center retrospective cohort study aims to compare the effectiveness of different surgical techniques used for curative treatment of PSD in children treated at CHU Angers between January 1, 2015 and March 31, 2025.
The primary endpoint is surgical failure at 2 months, defined as absence of complete wound healing or early recurrence. Secondary outcomes include postoperative complications, time to healing, pain outcomes, length of hospital stay, and recurrence at 1 year.
Results are expected to help optimize institutional management strategies and contribute to pediatric-specific evidence.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a single-center retrospective observational cohort study conducted in the Departments of Pediatric Surgery and Visceral Surgery at CHU Angers, France.
All consecutive patients under 18 years of age who underwent surgical treatment for pilonidal sinus disease between January 1, 2015 and March 31, 2025 will be included.
Surgical techniques analyzed include:
- Wide excision with open healing
- Wide excision with primary midline closure
- Wide excision with primary midline closure and negative pressure wound therapy
- Minimally invasive/endoscopic techniques The primary objective is to compare treatment effectiveness at 2 months postoperatively. Secondary objectives include comparison of complication rates, healing delay, postoperative pain, and recurrence at 1 year, as well as identification of predictive factors for recurrence.
Data will be extracted from medical records and anonymized prior to statistical analysis.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Françoise SCHMITT
- Phone Number: +33 0241353637
- Email: FrSchmitt@chu-angers.fr
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age < 18 years at time of surgery
- Surgical treatment for pilonidal sinus disease
- Surgery performed between January 1, 2015 and March 31, 2025
- Managed at CHU Angers (Pediatric or Visceral Surgery departments)
- ICD-10 diagnosis code L05.9
- CCAM procedure code QBFA007
Exclusion Criteria:
- Emergency incision and drainage of acute pilonidal abscess (CCAM QBPA001)
- Initial surgical management performed at another institution
- Refusal of participation (patient and/or legal guardians, if applicable)
- Alternative diagnosis (anal abscess, gluteal abscess)
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Wide excision with open healing
Intentional traditional treatment whitch consists in wide excision of the pilonidal sinus, and progressive healing of the wound thanks to daily dressing changes until complete closure is obtained.
|
curative treatment of pilonidal sinus, consisting in a wide excision followed by open healing or direct closure of the wound +/- negative pressure therapy dressing.
Alterantivelly, an endoscopic procedure to destroy the pilonidal sinus can be performed.
|
|
Wide excision with primary midline closure
Alternative technique using an immediate closure of the wound with layer of stiches, and regular dressings
|
curative treatment of pilonidal sinus, consisting in a wide excision followed by open healing or direct closure of the wound +/- negative pressure therapy dressing.
Alterantivelly, an endoscopic procedure to destroy the pilonidal sinus can be performed.
|
|
Wide excision with primary midline closure and negative pressure wound therapy
Alternative technique using an immediate closure of the wound with layer of stiches, completed with negative pressure therapy dressing, allowing for a fater recovery while requiring less dressing survey and changes.
|
curative treatment of pilonidal sinus, consisting in a wide excision followed by open healing or direct closure of the wound +/- negative pressure therapy dressing.
Alterantivelly, an endoscopic procedure to destroy the pilonidal sinus can be performed.
|
|
Minimally invasive/endoscopic techniques
Surgical treatment for pilonidal sinus disease, including various techniques including excision with or without primary closure, or endoscopic techniques.
|
curative treatment of pilonidal sinus, consisting in a wide excision followed by open healing or direct closure of the wound +/- negative pressure therapy dressing.
Alterantivelly, an endoscopic procedure to destroy the pilonidal sinus can be performed.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Failure rate
Time Frame: 2 months after surgery
|
Definition of failure:
|
2 months after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative complications
Time Frame: Up to 1 year
|
|
Up to 1 year
|
|
Time to complete wound healing
Time Frame: Up to 1 year
|
time in months
|
Up to 1 year
|
|
Length of hospital stay
Time Frame: at hospital discharge
|
duration of hospital stay in days
|
at hospital discharge
|
|
Postoperative pain duration
Time Frame: Up to 30 days
|
Up to 30 days
|
|
|
Postoperative pain Intensity
Time Frame: Up to 30 days
|
Up to 30 days
|
|
|
Analgesic consumption for postoperative pain
Time Frame: Up to 30 days
|
morphine equivalent dose
|
Up to 30 days
|
|
Predictive factors for recurrence
Time Frame: Up to last follow-up
|
bivariate and multivariate analysis
|
Up to last follow-up
|
|
Recurrence rate
Time Frame: Up to 1 year
|
Through study completion, average 6 month
|
Up to 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Françoise SCHMITT, University Hospital of Angers
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 49RC25_0350
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.