# Pilonidal Disease — GCMD Library living collection

Everything in the library about pilonidal disease — built automatically from dossiers that name it.

Updated: n/a · 9 episodes · 110 cited statements

## Episodes
### Medical Management
- [Update Course Rewind: Patient Education and Non-Surgical Management of Pilonidal Disease 2024](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514) — video · [machine version](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514.md)

### Surgical Management
- [Minimal Treatment of Pilonidal Disease - APSA Practice Gaps 2019](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305) — video · [machine version](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305.md)
- [Update Course Rewind: Pilonidal Disease 2019](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925) — podcast · 13:26 · [machine version](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925.md)
- [Update Course Rewind: Surgical Management of Pilonidal Disease 2024](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676) — video · [machine version](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676.md)

### Evidence & Research
- [BOB Ped Surg 2023 - Fereshteh Salimi Jazi, PAPS  - Presentation](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358) — video · [machine version](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358.md)
- [Burden of pilonidal disease and improvement in quality of life after treatment in adolescents](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225) — video · [machine version](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225.md)
- [Carga mental de la enfermedad pilonidal y mejora de la calidad de vida tras el tratamiento en adolescentes](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226) — video · [machine version](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226.md)
- [Journal of Pediatric Surgery Article Review: July 2023, PAPS Issue](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900) — podcast · 10:46 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900.md)

### Case-Based Learning
- [Pilonidal Cyst Case Presentation: Update Course 2015](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982) — video · 5:08 · [machine version](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982.md)

## Chapters
- [0:01](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=1) Case presentation and timing of definitive surgery (Ep 1)
- [0:54](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=54) Bascom pit-picking technique (Ep 1)
- [2:19](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=139) Risk factors affecting management (Ep 1)
- [2:43](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=163) Surgical options for definitive management (Ep 1)
- [3:34](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=214) Management of recurrent disease (Ep 1)
- [4:20](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=260) Laser hair removal as adjunct (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=0) Case presentation and technique evolution (Ep 2)
- [1:44](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=104) Minimal pit excision technique and rationale (Ep 2)
- [6:50](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=410) Operative setting and cavity debridement (Ep 2)
- [10:41](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=641) Wound healing management (Ep 2)
- [13:33](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=813) Research initiatives and adjunctive treatments (Ep 2)
- [17:03](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1023) Management of acute abscess presentation (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=0) Introduction and Case Presentation (Ep 3)
- [2:17](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=137) Rationale for GIPS Procedure Adoption (Ep 3)
- [4:53](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=293) GIPS Technique and Key Principles (Ep 3)
- [7:00](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=420) Adjunctive Techniques and Wound Management (Ep 3)
- [9:46](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=586) Antibiotic Use and Acute Abscess Management (Ep 3)
- [0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=0) Introduction and hypothesis (Ep 4)
- [1:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=60) Methods and patient categorization (Ep 4)
- [3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180) Patient demographics and laser session requirements (Ep 4)
- [5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300) Recurrence analysis and treatment target (Ep 4)
- [0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0) Quality of life impact of pilonidal disease and minimally invasive treatment outcomes (Ep 5)
- [0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0) Quality of life impact of pilonidal disease and minimally invasive surgical treatment in adolescents (Ep 6)
- [0:00](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=0) Introduction and Episode Overview (Ep 7)
- [1:08](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=68) Cryoanalgesia Impact on Pectus Excavatum Repair Outcomes (Ep 7)
- [3:20](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=200) Chest Tube Management After Pediatric Lung Resection (Ep 7)
- [6:08](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=368) Laser Hair Reduction for Pilonidal Disease Recurrence Prevention (Ep 7)
- [8:45](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=525) Summary and Closing Remarks (Ep 7)
- [0:00](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=0) Introduction and Session Overview (Ep 8)
- [1:10](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=70) Case Presentation and Treatment Decision-Making (Ep 8)
- [3:29](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=209) Hair Removal as Primary Intervention (Ep 8)
- [4:46](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=286) Practical Hair Removal Techniques and Hygiene Adjuncts (Ep 8)
- [6:31](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=391) Conclusion and Key Takeaways (Ep 8)
- [0:00](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=0) Introduction to Update Course Series and Pilonidal Disease Session (Ep 9)
- [0:50](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=50) Initial Management and Patient Presentation Patterns (Ep 9)
- [2:52](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=172) Minimally Invasive Surgical Approaches (Ep 9)
- [5:05](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=305) Technical Details and Evidence for Minimally Invasive Surgery (Ep 9)
- [6:48](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=408) Long-term Management and Graduated Treatment Approach (Ep 9)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- After 2-3 recurrences of pilonidal cyst, definitive surgery is indicated rather than repeat I&D. (opinion) [Ep 1 · 0:30](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=30)
- The Bascom technique involves excising 1-millimeter pits at skin level under local anesthesia, allowing secondary healing, with 70% not recurring by their data (though no control group exists). (clinical) [Ep 1 · 0:54](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=54)
- For large draining sinuses or recurrence after pit excision, formal OR excision of the entire affected area with off-midline layered closure and drain placement is performed. (clinical) [Ep 1 · 1:28](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=88)
- Physical exam findings including deep gluteal fold and heavy hair burden are high-risk factors for pilonidal disease recurrence. (clinical) [Ep 1 · 2:25](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=145)
- For severely infected pilonidal disease, open excision with wet-to-dry dressing changes or wound VAC is an option. (clinical) [Ep 1 · 2:50](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=170)
- Post-operative management with prone positioning until wound healing is critical for preventing recurrence; pilonidal disease is fundamentally a wound healing problem. (opinion) [Ep 1 · 3:43](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=223)
- Plastic surgery consultation for flap reconstruction with strict prone post-operative positioning is used for multiply recurrent pilonidal disease. (clinical) [Ep 1 · 3:54](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=234)
- One patient reported laser hair removal as the most painful procedure they had experienced, completing only half a session and refusing further treatment. (clinical) [Ep 1 · 4:28](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=268)
- Laser hair removal for pilonidal disease is expensive and insurance reimbursement has not been successful. (clinical) [Ep 1 · 4:46](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=286)
- Insurance coverage for laser hair reduction varies, with some agencies covering it while in Canada advocacy to health systems is needed, making effectiveness data important for coverage decisions. — Mary Brindle (opinion) [Ep 7 · 8:12](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=492)
- All three articles were chosen as PAPS Award winners at the annual conference. — Mary Brindle (clinical) [Ep 7 · 8:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=535)
- The three studies represent evolutionary (rather than revolutionary) advances important for day-to-day pediatric surgical care management. — Mary Brindle (opinion) [Ep 7 · 9:01](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=541)
- The patient presented with two previous abscess drainages (I&Ds) in the emergency department within the past 6 months — Steven Lee (clinical) [Ep 3 · 2:17](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=137)
- At UCLA, the institution was transitioning from unroofing and marsupialization to minimal pit excision for pilonidal disease management as of 2019 — Steven Lee (clinical) [Ep 3 · 2:45](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=165)
- The GIPS procedure was the most rapidly adopted technique ever presented at the update course — Todd Ponsky (opinion) [Ep 3 · 3:24](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=204)
- GIPS procedures can be done in the clinic or on an outpatient basis — Steven Lee (clinical) [Ep 3 · 3:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=234)
- The GIPS technique uses punch biopsies (trephines) to excise pits, followed by tract cleaning with a mosquito clamp — Todd Ponsky (clinical) [Ep 3 · 4:57](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=297)
- Some surgeons use sinus endoscopy (cystoscope) after pit excision to identify and remove remaining hair and granulation tissue from the cavity — Meera Kotagal (clinical) [Ep 3 · 5:31](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=331)
- The key principle is that excising all pits allows access to the cavity for thorough cleaning; leaving material behind leads to recurrence — Steven Lee (clinical) [Ep 3 · 6:30](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=390)
- Doctor Lee occasionally uses hydrogen peroxide to help clean out the tract but does not use sclerosing agents — Steven Lee (clinical) [Ep 3 · 7:07](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=427)
- Aggressive scraping of granulation tissue using Cottes and gauze is performed after hair removal — Steven Lee (clinical) [Ep 3 · 7:46](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=466)
- Traditional unroofing and marsupialization required roughly 4 to 6 weeks for complete healing — Steven Lee (clinical) [Ep 3 · 8:17](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- Weekly hair shaving is recommended during healing with one-week follow-up visits — Steven Lee (clinical) [Ep 3 · 8:17](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- If incisions close too early, silver nitrate can be used in clinic to keep the incisions open — Steven Lee (clinical) [Ep 3 · 8:17](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=497)
- The Midwest Pediatric Surgery Consortium is conducting a multi-center cohort study comparing largely invasive to minimally invasive procedures for pilonidal disease with standardized GIPS and medical management recommendations — Alex Cassar (clinical) [Ep 3 · 9:14](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=554)
- Doctor Lee does not use antibiotics for GIPS procedures unless there is an abscess, because wounds are left open to drain — Steven Lee (clinical) [Ep 3 · 10:05](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=605)
- No perioperative antibiotics are needed for GIPS procedures — Steven Lee (clinical) [Ep 3 · 10:05](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=605)
- Doctor Byerly performs GIPS even in the presence of acute abscess, using a vessel loop technique for the abscess cavity to allow better drainage — Elizabeth Byerly (clinical) [Ep 3 · 10:42](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=642)
- For patients with significant cellulitis or systemic illness, formal abscess drainage is preferred over immediate GIPS — Elizabeth Byerly (clinical) [Ep 3 · 10:42](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=642)
- Doctor Lee advocates draining abscesses off midline so that when the tract forms, it will be off midline — Steven Lee (clinical) [Ep 3 · 11:09](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=669)
- For emergency department drainage with significant inflammation and infection, adequate clean-out often cannot be achieved, so simple abscess drainage is recommended — Steven Lee (clinical) [Ep 3 · 11:09](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=669)
- Wide excision and packing is probably the most common operation that happens worldwide for pilonidal disease, with most pilonidal work not done by people doing advanced pilonidal work. — Nelson Rosen (clinical) [Ep 9 · 1:40](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=100)
- Antibiotics are not used unless patients are coming in with an active infection. — Nelson Rosen (clinical) [Ep 9 · 1:40](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=100)
- Some patients with minimal external manifestation don't drain very effectively and experience severe pain with large, bulging abscesses, while others present with multiple draining abscesses but typically don't report pain or require antibiotics. — Nelson Rosen (clinical) [Ep 9 · 1:40](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=100)
- Wide excision with off midline closure goes back to the 1960s when Caris first described it, and the Limberg flap has been used since the 1940s. (clinical) [Ep 9 · 2:29](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=149)
- Lord and Millard described a minimally invasive approach in 1965 that is almost the same operation Dr. Gibbs described in 2008. — Nelson Rosen (clinical) [Ep 9 · 2:52](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=172)
- Current success rates are closer to 70-75% where one minimally invasive operation gets you to full healing and lasting recurrence-free healing. — Nelson Rosen (epidemiological) [Ep 9 · 2:52](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=172)
- Some institutions use laser tract ablation, phenol to sclerose the tracts, or fibrin glue, but none have been proven superior. — Nelson Rosen (clinical) [Ep 9 · 2:52](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=172)
- For a first abscess, the approach is to drain it and see what you're dealing with. (clinical) [Ep 9 · 3:42](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=222)
- Minimally invasive approaches are offered quickly because it is a 20-minute intervention under sedation with no activity restriction and no narcotic requirement. — Nelson Rosen (clinical) [Ep 9 · 4:02](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=242)
- In the Gibbs procedure, all pits are excised using circular punches, then the internal cavity is scraped out to remove inflammation, hair, and necrotic fat, leaving the wounds open to heal. — Nelson Rosen (clinical) [Ep 9 · 4:53](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=293)
- The Ebzi procedure was described in 2013, doing everything through a small incision with a large scope that is not available in the United States. (clinical) [Ep 9 · 5:25](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=325)
- In the hybrid Gibbs approach, an eight French cystoscope is put into the openings after cleaning to make sure all hair is removed, and this has been done for the past five years with satisfaction. — Nelson Rosen (clinical) [Ep 9 · 5:42](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=342)
- If not starting with minimally invasive as the first surgical intervention for most people, you're doing it wrong. (opinion) [Ep 9 · 6:07](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=367)
- All patients should get laser hair removal once they're healed. — Nelson Rosen (opinion) [Ep 9 · 6:48](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=408)
- Patients need to be attentive to hair removal (waxing or laser) throughout adolescence and into adulthood, with the longer they can sustain it, the better. — Nelson Rosen (clinical) [Ep 9 · 6:48](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=408)
- Laser is not permanent but knocks hair down to a lower level. (clinical) [Ep 9 · 7:14](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=434)
- For patients where one or two minimally invasive approaches did not work and they have significant ongoing symptoms, the treatment moves to off-midline closure with the Bascom cleft lift as the preferred choice. (clinical) [Ep 9 · 7:14](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=434)
- Presence of hair in the gluteal crease is the most important predisposing risk factor for pilonidal disease — Fereshteh Salimi Jazi (clinical) [Ep 4 · 0:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=0)
- Study included 198 patients presenting from June 2019 to April 2022 — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 1:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=60)
- 102 patients were male and 96 patients were female — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180)
- Majority of patients had dark colored and medium thickness hair — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180)
- Majority of patients had Fitzpatrick skin types three and four — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180)
- Mean age at time of first laser session was 18 years — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180)
- Median follow-up time was 217 days — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 3:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=180)
- A linear relation was observed between number of laser sessions and amount of hair reduction regardless of patient hair and skin characteristics — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- On average, 2.6 laser sessions required to reach 20% hair reduction — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- On average, 4.3 sessions required to reach 50% hair reduction — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- On average, 6.6 sessions required to reach 75% hair reduction — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- On average, 7.8 sessions required to reach 90% hair reduction — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- Patients with Fitzpatrick skin types 1 and 2 required less average laser sessions to reach the same percentage of hair reduction compared to other skin type groups — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- Thicker hair was associated with higher average laser sessions required — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- Dark colored hair was associated with higher average laser sessions required — Fereshteh Salimi Jazi (clinical) [Ep 4 · 4:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=240)
- 44 patients underwent incision and drainage at time of presentation — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- 132 patients underwent trephination procedure — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- 22 patients did not undergo any surgical intervention under study care — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- Overall recurrence rate was 6% — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- None of the patients with more than 75% hair reduction experienced recurrence — Fereshteh Salimi Jazi (clinical) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- After controlling for other confounding factors, dark hair was associated with higher recurrence rate — Fereshteh Salimi Jazi (clinical) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- After controlling for other confounding factors, Fitzpatrick skin types five and six were associated with higher recurrence rate — Fereshteh Salimi Jazi (clinical) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- Mean number of laser sessions after which recurrence occurred was 3.2 sessions — Fereshteh Salimi Jazi (epidemiological) [Ep 4 · 5:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=300)
- Probability of recurrence decreases with increase in percentage of hair reduction — Fereshteh Salimi Jazi (clinical) [Ep 4 · 6:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=360)
- Probability of recurrence after 20% hair reduction decreased by 50% — Fereshteh Salimi Jazi (clinical) [Ep 4 · 6:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=360)
- Probability of recurrence after 50% hair reduction decreased by 78% — Fereshteh Salimi Jazi (clinical) [Ep 4 · 6:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=360)
- Probability of recurrence after 75% hair reduction decreased by 100% — Fereshteh Salimi Jazi (clinical) [Ep 4 · 6:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=360)
- 75% hair reduction could be a treatment target for pilonidal disease patients since no recurrence occurred after achieving this threshold in the study cohort — Fereshteh Salimi Jazi (opinion) [Ep 4 · 6:00](https://origin-library.globalcastmd.com/watch/bob-ped-surg-2023-fereshteh-salimi-jazi-paps-presentation-6358?t=360)
- Patients presenting with wounds as their initial presentation for pilonidal tend to not always get to the finish line fully healed with a minimally invasive approach — M. Godi (clinical) [Ep 8 · 2:12](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=132)
- 60 to 70% of pilonidal cases respond successfully to non-surgical management — Nelson Rosen (clinical) [Ep 8 · 2:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=174)
- If you're not pushing hair removal and meticulous hygiene to do the best that you can, you're probably going to end up operating on some people that might not need an operation — Nelson Rosen (opinion) [Ep 8 · 3:29](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=209)
- Many patients have come from multiple hospitals full of hair with nobody clipping them in the office or mentioning hair removal — Nelson Rosen (clinical) [Ep 8 · 4:20](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=260)
- Clipping is probably the easiest and simplest approach for hair removal when a parent or active caregiver is involved (opinion) [Ep 8 · 4:46](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=286)
- Having someone clip the area once a week is recommended — Nelson Rosen (guideline) [Ep 8 · 4:46](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=286)
- For college students living alone without caregivers, depilatory agents (Nair) are recommended as an alternative to clipping — Nelson Rosen (guideline) [Ep 8 · 5:11](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=311)
- Wax strips can be used intraoperatively during general anesthesia to remove hair from the natal cleft and buttocks area (clinical) [Ep 8 · 5:37](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=337)
- Proper showering with a hand shower to actually put water in the affected area is important for healing — Nelson Rosen (guideline) [Ep 8 · 6:03](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=363)
- Many patients report being told they couldn't bathe, which is problematic because without washing, healing is unlikely — Nelson Rosen (clinical) [Ep 8 · 6:03](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=363)
- Staging systems for pilonidal disease have been introduced previously, but not all classifications correlate with how cases are managed — Nelson Rosen (clinical) [Ep 8 · 1:34](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=94)
- Treatment decisions should be tailored to patient context, such as a 16-year-old baseball player who is miserable may proceed directly to operating room — Nelson Rosen (opinion) [Ep 8 · 2:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=174)
- Non-surgical management allows patients to return to activities of daily living immediately, though partial healing may occur depending on disease severity (clinical) [Ep 8 · 3:05](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=185)
- Less invasive techniques for pilonidal disease lead to improved outcomes with respect to healing times, recovery times, and decreased need for additional operations and recurrence rates (clinical) [Ep 2 · 1:16](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=76)
- The minimal pit excision topic was the most rapidly adopted change from all update course topics, with surgeons switching techniques immediately after the presentation (opinion) [Ep 2 · 1:16](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=76)
- The pits procedure uses trephines or punch biopsies to excise the tract, then cores out everything underneath to clean it out (clinical) [Ep 2 · 3:30](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=210)
- Unroofing and marsupialization healing time was roughly four to six weeks for complete healing (clinical) [Ep 2 · 12:12](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=732)
- Hydrogen peroxide is used during the procedure, though its actual benefit is uncertain (clinical) [Ep 2 · 6:50](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=410)
- Initial cases can be performed in OR under sedation and local anesthesia without requiring general anesthetic as an outpatient procedure (clinical) [Ep 2 · 6:50](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=410)
- Phenol has been used as a sclerosing agent, with some filling air pockets or sinuses to sclerose granulation tissue (clinical) [Ep 2 · 8:41](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=521)
- A paper on phenol use was published in the current issue of Journal of Pediatric Surgery (clinical) [Ep 2 · 9:41](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=581)
- Curettes are used to aggressively scrape out granulation tissue from the cavity (clinical) [Ep 2 · 10:12](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=612)
- Mosquito clamps or similar instruments are used to pull out hair from the cavity (clinical) [Ep 2 · 10:12](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=612)
- The area should be kept free of hair during healing with weekly shaving and one-week follow-up visits (clinical) [Ep 2 · 12:12](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=732)
- If incisions start to close too early, silver nitrate can be applied in clinic to keep the incisions open (clinical) [Ep 2 · 13:00](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=780)
- Vessel loops or drains left in place caused more pain and developed more granulation tissue along the track (clinical) [Ep 2 · 13:33](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=813)
- Half of hospitals and half of surgeons in the Midwest Pediatric Surgical Consortium had never done or seen a pits procedure — Alex (epidemiological) [Ep 2 · 13:55](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=835)
- The Midwest Pediatric Surgical Consortium multi-center cohort study will compare minimally invasive to more invasive procedures with primary outcome of recurrence at one year — Alex (clinical) [Ep 2 · 13:55](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=835)
- Secondary outcomes for the consortium study include time to healing, quality of life, cost, antibiotic use, narcotic use, days of pain, days unable to perform activities, return to school, and return to sports — Alex (clinical) [Ep 2 · 15:21](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=921)
- The consortium pilonidal study received funding in May — Alex (clinical) [Ep 2 · 15:21](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=921)
- Laser hair removal is not covered by insurance and patients often cannot afford it — Alex (clinical) [Ep 2 · 16:10](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=970)
- Antibiotics are not needed for minimally invasive pilonidal surgery unless there is an abscess, because wounds are left open to drain (clinical) [Ep 2 · 17:03](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1023)
- Vessel loop technique can be used after pits procedure in the setting of abscess to allow better drainage (clinical) [Ep 2 · 18:11](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1091)
- When draining pilonidal abscess in the emergency department, the incision should be made off midline so the resulting tract will be off midline (clinical) [Ep 2 · 19:05](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1145)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- The Karydakis flap is superior to excision only and comparable to the modified Limberg flap for pilonidal disease. — The host summarizing the discussion [Ep 1 · 3:10](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=190)
- The modified elliptical rotation flap has short-term results comparable to Limberg and Karydakis flaps, though less data exists. — The host summarizing the discussion [Ep 1 · 3:10](https://origin-library.globalcastmd.com/watch/pilonidal-cyst-case-presentation-update-course-2015-982?t=190)
- The cryoanalgesia study compared patients from 2011 to 2021, with 29 patients receiving cryoanalgesia and 15 not receiving it. — Cecilia Gigena summarizing the discussion [Ep 7 · 1:39](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=99)
- Patients who received cryoanalgesia had shorter hospital stays: 3.0 days versus 5.4 days for those without cryoanalgesia. — Cecilia Gigena summarizing the discussion [Ep 7 · 1:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=108)
- Hospital costs were slightly lower (less than $1000 difference) in patients who received cryoanalgesia despite the expensive equipment. — Cecilia Gigena summarizing the discussion [Ep 7 · 2:00](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=120)
- Cryoanalgesia was associated with a 70% decrease in complication rates, from approximately 33% down to 17%. — Mary Brindle summarizing the discussion [Ep 7 · 2:31](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=151)
- The chest tube study included 130 lung resections performed between 2013 and 2022. — Mary Brindle summarizing the discussion [Ep 7 · 3:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=228)
- Of the 130 procedures, 59 were lobectomies (group 1), 19 were diagnostic wedge resections (group 2), and 52 were excisional wedge resections (group 3). — Em Gootee summarizing the discussion [Ep 7 · 3:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=235)
- In lobectomy patients (group 1), 75% had no air leak and median chest tube duration was 2 days. — Jamie Schnuck summarizing the discussion [Ep 7 · 4:12](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=252)
- In diagnostic wedge resection patients (group 2), nearly 90% had no air leak and median chest tube duration was 1 day. — Em Gootee summarizing the discussion [Ep 7 · 4:30](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=270)
- In excisional wedge resection patients (group 3), 80% had no air leak and median chest tube duration was 1 day. — Em Gootee summarizing the discussion [Ep 7 · 4:39](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=279)
- Most chest tubes were removed on the first day after surgery and a majority of patients did not have an air leak. — Jamie Schnuck summarizing the discussion [Ep 7 · 4:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=288)
- The pilonidal disease study included 198 patients presenting between 2019 and 2022, with data prospectively gathered in a retrospective study design. — Mary Brindle summarizing the discussion [Ep 7 · 6:37](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=397)
- The pilonidal disease cohort included 21 patients with skin types 1-2, 156 with skin types 3-4, and 21 with skin types 5-6, with approximately 151 having dark colored hair. — Cecilia Gigena summarizing the discussion [Ep 7 · 6:51](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=411)
- To reach 75% hair reduction requires a mean of 4.8 to 6.8 laser ablation sessions depending on skin and hair characteristics. — Cecilia Gigena summarizing the discussion [Ep 7 · 7:34](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=454)
- Dark hair and skin types 5-6 were associated with higher recurrence rates in pilonidal disease after laser hair reduction. — Cecilia Gigena summarizing the discussion [Ep 7 · 7:47](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=467)
- The overall recurrence rate for pilonidal disease after laser hair reduction was 6%. — Cecilia Gigena summarizing the discussion [Ep 7 · 7:47](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-july-2023-paps-issue-7900?t=467)
- Doctor Lee sometimes performs GIPS procedures in his office — Steven Lee summarizing the discussion [Ep 3 · 3:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=234)
- GIPS procedure shows improved outcomes with respect to healing times, recovery times, and decreased need for additional operations and recurrence rates compared to traditional open excisions — Steven Lee summarizing the discussion [Ep 3 · 4:34](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=274)
- For recurrences, minimally invasive tactics can be repeated, including pit picking technique where hairs are plucked out — Steven Lee summarizing the discussion [Ep 3 · 6:30](https://origin-library.globalcastmd.com/watch/update-course-rewind-pilonidal-disease-2019-3925?t=390)
- In Dr. Gibbs's study, they had a 15% recurrence rate over 10 years. — Nelson Rosen summarizing the discussion [Ep 9 · 2:52](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=172)
- A Swedish study by Roland Anderson in 2017 with 113 patients used a minimally invasive approach with suture closure of all but one hole (left open to drain) and had excellent results. — The host summarizing the discussion [Ep 9 · 6:07](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=367)
- A large prospective study by Nationwide Children's on laser hair removal after surgery found it significantly reduced recurrent disease, representing the first randomized prospective study on this subject. — The host summarizing the discussion [Ep 9 · 6:07](https://origin-library.globalcastmd.com/watch/update-course-rewind-surgical-management-of-pilonidal-disease-2024-9676?t=367)
- John Armstrong in the United States Army had a clinic where patients were shaved weekly and closely monitored, leading to dramatic improvement and a reduced need for surgery — M. Godi summarizing the discussion [Ep 8 · 3:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=234)
- A large percentage of patients will be healed with non-surgical measures alone — M. Godi summarizing the discussion [Ep 8 · 3:54](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=234)
- Washlets can be helpful adjuncts for patients who struggle to clean themselves after bowel movements — M. Godi summarizing the discussion [Ep 8 · 6:31](https://origin-library.globalcastmd.com/watch/update-course-rewind-patient-education-and-non-surgical-management-of-pilonidal-9514?t=391)
- This is a prospective observational study conducted in the United States that evaluated quality of life in patients with pilonidal cysts before and after minimally invasive surgery. — Cecilia Gigena summarizing a resource [Ep 6 · 0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0)
- The study included 101 patients with pilonidal cysts who underwent minimally invasive surgery. — Cecilia Gigena summarizing a resource [Ep 6 · 0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0)
- Before surgery, daily activities were affected in 66% of patients, sports capacity in 57%, school attendance in 45%, and social activities in 22%. — Cecilia Gigena summarizing a resource [Ep 6 · 0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0)
- After surgery, daily activities were affected in only 7% of patients, sports in 8%, school attendance in 2%, and social activities in 4%. — Cecilia Gigena summarizing a resource [Ep 6 · 0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0)
- Minimally invasive surgery for pilonidal cysts appears to be highly beneficial for patient quality of life. — Cecilia Gigena summarizing a resource [Ep 6 · 0:00](https://origin-library.globalcastmd.com/watch/carga-mental-de-la-enfermedad-pilonidal-y-mejora-de-la-calidad-de-vida-tras-el-t-7226?t=0)
- A US observational study assessed quality of life in patients with pilonidal disease before and after minimally invasive treatment. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- The study enrolled 101 patients with pilonidal disease who underwent minimally invasive treatment. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Prior to surgery, daily activities were reduced by 66% in patients with pilonidal disease. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Prior to surgery, sports participation was reduced by 57% in patients with pilonidal disease. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Prior to surgery, school or work attendance was reduced by 45% in patients with pilonidal disease. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Prior to surgery, social skills were reduced by 23% in patients with pilonidal disease. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- After minimally invasive repair, daily activities were reduced by only 7%. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- After minimally invasive repair, sports participation was reduced by only 8%. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- After minimally invasive repair, school or work attendance was reduced by only 2%. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- After minimally invasive repair, social skills were reduced by only 4%. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Minimally invasive treatment for pilonidal disease improves quality of life in patients. — Cecilia Gigena summarizing a resource [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/burden-of-pilonidal-disease-and-improvement-in-quality-of-life-after-treatment-i-7225?t=0)
- Aaron Lipscar presented the pits procedure at a previous session — The host summarizing the discussion [Ep 2 · 1:16](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=76)
- Nelson Rosen uses sinus endoscopy with a cystoscope after pit excision to identify and remove remaining hair and debris from the cavity — The host summarizing the discussion [Ep 2 · 4:30](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=270)
- Nationwide Children's Hospital is conducting an NIH-funded study on laser hair removal for pilonidal disease with promising early data — The host summarizing the discussion [Ep 2 · 14:51](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=891)
- Rock salt works as well as silver nitrate to keep skin open during healing — The host summarizing the discussion [Ep 2 · 16:34](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=994)
- The initial pits technique paper describes performing pits even in the presence of acute abscess without staging — The host summarizing the discussion [Ep 2 · 17:29](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1049)
- Tony Sandler in DC uses the vessel loop technique for abscess drainage with pits — The host summarizing the discussion [Ep 2 · 18:41](https://origin-library.globalcastmd.com/watch/minimal-treatment-of-pilonidal-disease-apsa-practice-gaps-2019-2305?t=1121)

## Changelog
- Sep 24: 6 items added automatically
- Sep 17: 3 items added automatically

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