Premium
Smoking increases the risk of pre‐ and postoperative complications in patients with pilonidal disease
Author(s) -
Iesalnieks Igors,
Deimel Sina,
Zülke Carl,
Schlitt Hans J.
Publication year - 2013
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12140
Subject(s) - pilonidal disease , medicine , natural history , surgery , disease , smoking history
Summary Background Smoking has a negative impact on the natural history and on treatment results of many dermatological conditions. However, there are no data demonstrating a similar effect in patients with pilonidal disease. Patients and Methods Consecutive patients undergoing surgery for pilonidal disease between 1/2004 and 3/2012 were analyzed retrospectively. Two surgical methods were used: a minimally invasive “pit‐picking” surgery for smaller primary disease and Karydakis flap for patients presenting with larger primary disease or those who have been operated previously. The aim of the present study was to analyze the impact of smoking on the natural history and on treatment results. Results Six hundred and ten patients underwent 660 surgeries: 475 pit‐picking operations and 185 Karydakis procedures. Smokers had developed a pilonidal abscess at least once during their disease significantly more often than non‐smokers (48% vs. 26%, p = 0.00001). The recurrence rate following the pit‐picking procedure was significantly increased in smokers (1‐year recurrence rate: 36% vs. 21%, p = 0.008). After the Karydakis procedure, smokers developed more wound complications than non‐smokers (29% vs. 10%, p = 0.005). The recurrence rate after the Karydakis flap was non‐significantly increased in smokers (9% vs. 7% at 1 year, p = 0.07). Conclusions Smoking has a detrimental effect on the natural history and on treatment results of pilonidal disease. Patients should be encouraged to cease smoking prior to pilonidal surgery.