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<p>The aim of the guidelines is to provide optimal treatment recommendations based on an evidence-based literature search. In this version recommendations for the treatment of children and adolescents have been included for the first time.</p><p>There are three forms of pilonidal sinus: the asymptomatic condition without exudation, the acutely abscessing pilonidal sinus and the chronically symptomatic pilonidal sinus. Currently, there is no treatment that meets all the requirements of a&#xa0;simple, painless treatment with rapid wound healing and a&#xa0;low recurrence rate.</p><p>An asymptomatic pilonidal sinus does not require treatment. An abscess should be promptly and sufficiently surgically drained. Minimally invasive techniques represent a&#xa0;primary treatment option for localized uncomplicated chronic forms, although a&#xa0;higher recurrence rate must be expected compared to excision techniques. Otherwise, in chronic sinus cases surgical excision with or without subsequent closure is the standard treatment. As an alternative to open wound treatment, which can be associated with complications, plastic (asymmetrical) techniques and displacement flaps (Limberg and Karydakis flaps) are available. Laser hair removal may be useful in selected cases, although evidence-based recommendations only support its use as a&#xa0;supplement to surgical treatment in young people under the age of 22.</p><p>All procedures described for adults are available for the treatment of peritoneal sinus in children and adolescents, although the recurrence rate is significantly higher in this age group. There is a&#xa0;clear recommendation in favour of using minimally invasive techniques.</p>

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S3-Leitlinie – Sinus pilonidalis, Version 3.0

  • 期刊论文

  • 发表日期：

    2026年4月16日

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  • A. Ommer,
  • I. Iesalnieks,
  • D. Doll,
  • S. Petersen,
  • V. Kahlke,
  • J. Schneider,
  • M.-Ch. Stefanescu,
  • Ch. Oetzmann von Sochaczewski,
  • Juliane Kirsch,
  • C. Breitkopf,
  • D. Bussen,
  • A. Fürst,
  • H. Krammer,
  • F. Kühn,
  • M. Stoll,
  • T. Laubert,
  • M. Sailer,
  • O. Schwandner

摘要

The aim of the guidelines is to provide optimal treatment recommendations based on an evidence-based literature search. In this version recommendations for the treatment of children and adolescents have been included for the first time.

There are three forms of pilonidal sinus: the asymptomatic condition without exudation, the acutely abscessing pilonidal sinus and the chronically symptomatic pilonidal sinus. Currently, there is no treatment that meets all the requirements of a simple, painless treatment with rapid wound healing and a low recurrence rate.

An asymptomatic pilonidal sinus does not require treatment. An abscess should be promptly and sufficiently surgically drained. Minimally invasive techniques represent a primary treatment option for localized uncomplicated chronic forms, although a higher recurrence rate must be expected compared to excision techniques. Otherwise, in chronic sinus cases surgical excision with or without subsequent closure is the standard treatment. As an alternative to open wound treatment, which can be associated with complications, plastic (asymmetrical) techniques and displacement flaps (Limberg and Karydakis flaps) are available. Laser hair removal may be useful in selected cases, although evidence-based recommendations only support its use as a supplement to surgical treatment in young people under the age of 22.

All procedures described for adults are available for the treatment of peritoneal sinus in children and adolescents, although the recurrence rate is significantly higher in this age group. There is a clear recommendation in favour of using minimally invasive techniques.