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<p>A&#xa0;variety of treatment options are available for the treatment of a&#xa0;pilonidal sinus, which can be classified into three categories: minimally invasive, open treatment and plastic reconstructive procedures. The third category, namely excision and plastic reconstructive closure, includes the Limberg flap and Karydakis flap as the most frequently used procedures at present.</p><p>Plastic reconstructive procedures have demonstrated their value over excision and open wound treatment through evidence-based benefits of rapid wound healing, significantly reduced pain in the postoperative phase, and a&#xa0;low recurrence rate.</p><p>High costs arise from the time-consuming procedure, with an operation duration of approximately 45&#xa0;min as well as costs for anesthesia and perioperative care. Therefore, outpatient surgical treatment with flap surgery under the hybrid diagnosis-related groups (DRG) system is not financially viable. In addition, outpatient care for patients entails a&#xa0;significant additional effort.</p><p>The dilemma is that while inpatient treatment enables the costs of the surgical intervention with plastic reconstruction to be covered, this can only be billed if there is precise and detailed documentation of the indications and the substantial additional nursing efforts associated with it.</p>

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Sinus pilonidalis – sind plastische Verfahren im Hybrid-Diagnosis-Related Groups(DRG)-Zeitalter noch möglich?

  • 期刊论文

  • 发表日期：

    2025年11月12日

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  • Sven Petersen,
  • Alexander Krebs

摘要

A variety of treatment options are available for the treatment of a pilonidal sinus, which can be classified into three categories: minimally invasive, open treatment and plastic reconstructive procedures. The third category, namely excision and plastic reconstructive closure, includes the Limberg flap and Karydakis flap as the most frequently used procedures at present.

Plastic reconstructive procedures have demonstrated their value over excision and open wound treatment through evidence-based benefits of rapid wound healing, significantly reduced pain in the postoperative phase, and a low recurrence rate.

High costs arise from the time-consuming procedure, with an operation duration of approximately 45 min as well as costs for anesthesia and perioperative care. Therefore, outpatient surgical treatment with flap surgery under the hybrid diagnosis-related groups (DRG) system is not financially viable. In addition, outpatient care for patients entails a significant additional effort.

The dilemma is that while inpatient treatment enables the costs of the surgical intervention with plastic reconstruction to be covered, this can only be billed if there is precise and detailed documentation of the indications and the substantial additional nursing efforts associated with it.