What causes recurrent pilonidal disease?

Updated: Jun 11, 2018
  • Author: M Chance Spalding, DO, PhD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Patients with recurrent pilonidal disease or complex, unhealed pilonidal wounds present a challenge to the surgeon. Tissue loss from previous attempts at excision further complicates the surgical management and limits options. The causes of recurrence are thought to include the following:

  • Unrecognized sinus at the time of the initial excision
  • Repeated infections of the scar, causing abscess
  • Intergluteal cleft anatomy that promotes the accumulation of perspiration, friction, and the tendency for hair to grow into the scar

The midline scar is the most susceptible to the recurrence of pilonidal disease and poor wound healing.

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