Smoking increases the risk of pre- and postoperative complications in patients with pilonidal disease
Version of Record online: 15 AUG 2013
© The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 11, Issue 10, pages 1001–1005, October 2013
How to Cite
Iesalnieks, I., Deimel, S., Zülke, C. and Schlitt, H. J. (2013), Smoking increases the risk of pre- and postoperative complications in patients with pilonidal disease. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 11: 1001–1005. doi: 10.1111/ddg.12140
- Issue online: 25 SEP 2013
- Version of Record online: 15 AUG 2013
- Manuscript Accepted: 18 APR 2013
- Manuscript Received: 20 MAR 2013
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.
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).
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.