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Research Letter |

Short- and Long-term Results of Unroofing and Marsupialization for Adolescent Pilonidal Disease

Joshua D. Rouch, MD1; Jessica A. Keeley, MD2; Andrew Scott, MD1; Roman Sydorak, MD3; Daniel DeUgarte, MD1; Steven L. Lee, MD2
[+] Author Affiliations
1Division of Pediatric Surgery, University of California–Los Angeles
2Division of Pediatric Surgery, Harbor–University of California–Los Angeles Medical Center, Los Angeles
3Department of Surgery, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, California
JAMA Surg. 2016;151(9):877-879. doi:10.1001/jamasurg.2016.0850.
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This case series compares unroofing and marsupialization vs wide local excision as surgical therapy for pilonidal disease.

Pilonidal disease is a benign and often chronic condition of the skin/soft tissue in the sacrococcygeal region. For failed response to nonoperative management, there is currently no consensus among a variety of different operative techniques.1,2 Currently, wide local excision (WLE) with or without closure is advocated by many.3,4 This technique is characterized by wide excision of all involved tissue. This is followed by operative closure or is allowed to heal by secondary intention. These therapies can result in significant morbidity, long healing times, and high risk for recurrence. Flap techniques are durable but difficult to learn and require drains and/or prolonged immobilization.5

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