5th International Pilonidal Conference Summary
Photos kindly provided by Dr Steve Immerman
click here for programme
SESSION 1
Ida Faurschou
- incidence in Denmark 57 male and 23 female / 100,000 (avg 40)
- Türkiye: 1/4 females asymptomatic and 1/2 male
- higher recurrence rate in <18 years, females, family history
Susanne Haas
- literature is highly variable
- sex hormones have wide-ranging impact on skin and hair
- asymptomatic prevalence of midline sinuses in Turkish school aged children 2.6/1000
Peter Wysocki
- clinical diagnosis
- key differential diagnosis: fistula-in-ano, HS
- MRI / EUA if suspect fistula
- differentiate acute / mild / severe
Dotun Ojo
- Quality of Life measures allow patient voice to be heard more clearly
- St Mark's is developing PNQoL-12
- 3 themes: emotional and social well being, self-image & hygiene, practical & functional burden
SESSION 2
Live mini-Delphi : research priorities
Join the working group
Phillip Tozer: Interunit collaboration
- orphan disease with limited understanding of aetiology
- cognitive diversity is key to a valuable research collaborative
- more people = better ideas
Susanne Hass: International opportunities for research
- introduced PILO-ACT snapshot audit on abscess management
Short paper presentations abstracts have been published in Pilonidal Sinus Journal Vol. 11 No. 2 (2025)
INAUGURAL KEYNOTE LECTURE by Dr Steve Brown
- tailor surgery to disease severity
- avoid obsolete operations eg wide local excision
- better training and referral systems
- ask what the patient wants: recovery vs definitive cure
SESSION 3
Dr Robert Smeenk compared the international literature showing wide variations in practice
Jon Lund: Traditional and Non-invasive procedures
- don't make the treatment worse than the disease
- pit picking
- fibrin glue
- Bascom 1
Greg Thomas: New non-excisional procedures
- exact indication needs to be clarified due to poor evidence base
Peter Wysocki: Excisional Options
- not all flaps are the same
- only Cleft Lift and Karydakis flap scars do not cross the midline
- Limberg Flap design is complex
- other flaps contraindicated as the surgical wound crosses midline
Dr Steve Immerman outlined the steps for a successful cleft lift
Asha Senapati: Treatment Algorithm
- Type 1 = Gips or equivalent
- Type 2 = Bascom 1 / EPSiT or equivalent
- Type 3 = off midline cleft closure
- Type 4 = Cleft Lift / Karydakis
SESSIONS 4 and 5: Pannel Discussion
- stop doing excision with open healing
- stop doing midline closure
- sinus based procedures for simple disease
- use of drain is controversial / how to identify the few patients who may benefit
- definitive use of laser
- smoking may not impair wound healing in this patient sample
- expensive equipment being used with no cost analysis data
- definition of recurrence is complex
- case based discussions demonstrated variety of practice
- indication for Gips trephine vs Bascom 1
CONGRATULATIONS TO SHORT PAPERS WINNER - Ida Faurschou
next meeting TBA soon
