General Surgeons’ Approach to Pilonidal Abscess in Turkey: Results of a Nationwide Survey

Abstract

Aim: This nationwide survey study aimed to determine the initial and definitive treatment strategies for pilonidal abscess (PA) that are used by general surgeons in Turkey. Method: Surgeons working at centers in Turkey were sent an electronic questionnaire focusing on diagnostic, perioperative, and postoperative management options for PA. The questions were prepared based on an extensive assessment of the literature and were evaluated for usability prior to distribution. A survey consisting of 20 questions was sent to surgeons and surgical residents via email. The survey link was kept active for 1 month to give the surgeons enough time to complete it. Results: Of the 520 participants, 64% defined themselves as general surgeons and 9.5% as colorectal surgeons. The most preferred surgical approaches among the participants were as follows: day surgery unit (75.2%), local anesthesia (82.8%), and drainage through the most fluctuant location (65.1%). Irrigation of the cavity was applied by 70% of the participants (38.8% with saline and 32.3% with hydrogen peroxide). The majority (82.5%) prescribed oral antibiotics following PA drainage. Definitive treatment was scheduled within a timeframe of 4-8 weeks by 45.6%. Participants who performed concurrent phenol application were more likely to perform a definitive treatment if the patient becomes symptomatic (p<0.001, odds ratio: 10,819, 95% confidence interval: 2,682-43,645). Conclusion: The study revealed that there are different approaches to the management of PA among surgeons in Turkey. Guidelines and consensus studies should be conducted to achieve the best results in the management of PA.