GuidelineLangenbeck's archives of surgery2021
German National Guideline on the management of pilonidal disease: update 2020.
Guideline in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05851690 (Bilaterally Parallel Elliptic Flap Versus Karydakis Flap in Pilonidal Sinus Disease), which is not on this map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bilaterally Parallel Elliptic Flap Versus Karydakis Flap in Pilonidal Sinus Disease: A Randomized Controlled Trial
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- International Society of Laser Proctology Position Paper on SiLaC and EPSiT/SiLaC in the Management of Pilonidal Sinus Disease.Lasers in surgery and medicine · 2025Guideline
- Midline and off-midline wound closure methods after surgical treatment for pilonidal sinus.The Cochrane database of systematic reviews · 2024Pooled it
- Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature.Frontiers in surgery · 2021Pooled it
- Effect of sinus resection combined with vacuum-assisted closure on sacrococcygeal pilonidal sinus.International wound journal · 2023Trial
- The role of alginate dressings in wound healing and quality of life after pilonidal sinus resection: A randomised controlled trial.International wound journal · 2022Trial
- Surgical Treatment Outcomes for Primary Pilonidal Sinus Disease: A Single-Centre Retrospective Study of 2222 Patients (2006-2020).International wound journal · 2026Article
- The Pilonidal Sinus Disease-Specific Quality of Life Questionnaire (SQoL): Reliability, Validity, and Utilisation.Journal of clinical medicine · 2026Article
- Shrinking follow-up duration in pilonidal sinus surgery, 1970-2020: a patient-weighted longitudinal analysis of 2,285 studies.Langenbeck's archives of surgery · 2026Review
- Negative pressure wound therapy in children: outcomes across a heterogeneous wound cohort.Pediatric surgery international · 2026Article
- Phenol for pilonidal sinus disease: a nationwide survey of practice patterns and safety gaps among surgeons in Türkiye.BMC health services research · 2026Article
- Limberg flap reconstruction for recurrent pilonidal sinus disease: A single-center U.S. Cohort.Langenbeck's archives of surgery · 2026Article
- Recurrence Patterns in Pilonidal Sinus Disease Surgery: Navigating Misclassifications and Early Complications.Revista do Colegio Brasileiro de Cirurgioes · 2026Article
- Article
- Pilonidal disease: Gaps in the guidelines and future perspectives.Turkish journal of surgery · 2025Article
- Microbiome, mechanics, and morphology: Rethinking the etiopathogenesis of pilonidal sinus disease.Turkish journal of surgery · 2025Article
- Practice patterns of paediatric surgeons on treating pilonidal sinus disease - a national survey study.International journal of colorectal disease · 2025Article
- Impact of surgical case load on recurrence rates in pilonidal sinus disease: a cross-study data synthesis.International journal of colorectal disease · 2025Article
- A Comparative Analysis of Pain Assessment Methods in the Initial Postoperative Phase Following Different Pilonidal Cyst Surgeries.Medicina (Kaunas, Lithuania) · 2024Article
- Closed-incision negative-pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe present German National Guideline is an updated version of previous Guideline published in 2014. It aims to compare various treatment methods and to assist physicians with evidence-based recommendations.
methodsSystemic literature review.
resultsThree types of disease manifestation could be differentiated: asymptomatic disease, an acute abscess, and the chronic pilonidal disease. At present, there is no treatment method fulfilling all desired criteria: simple, painless procedure associated with rapid wound healing, and low recurrence rate. Thus, treatment modality should be tailored to disease manifestation and extent.
conclusionAsymptomatic pilonidal disease should not be treated. A pilonidal abscess should be unroofed. After resolution of the acute inflammation, the disease should be treated definitely. As for today, sinus excision is the standard treatment of the chronic pilonidal disease. Wide excision and open treatment of chronic disease is a safe procedure which, however, leads to prolonged secondary healing and time off-work, as well as to considerable recurrence rate. The extent of excision should be as limited as possible. Excision and midline wound closure is associated with impaired outcomes. Today, it has become obsolete. Minimally invasive procedures (e.g., pit picking surgery) represent a treatment option for chronic pilonidal disease. However, the recurrence rate is higher compared to excision procedures. Nevertheless, they may be used for small primary disease. Off-midline procedures should be used for disease not suitable for minimally invasive treatments. The Limberg flap and the Karydakis procedure are two best described methods which are associated with similar short- and long-term results.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.