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Pilonidal Disease Severity Staging Correlates with Risk of Recurrence

Synopsis by Lewis Flint, MD, FACS

June 17, 2025

acs-store-journalperiodical.jpg

Chiu B, Thobani H, Abrajano C, et al. Standardized Classification System for Pilonidal Disease and Recurrence Rate after Treatment. J Am Coll Surg. 2025, in press.

The authors reported a prospective cohort study (n = 411) conducted to validate a pilonidal disease severity staging system.

The staging system is clearly described in the article; severity grade is determined by presence of pits, symptoms, and granuloma and/or secondary sinus formation. Photographs of pilonidal sinus lesions at each staging level are also provided.

Recurrence rates were closely associated with severity grades at 1-year (0% for grade 0 and 20.8% for grade 3) and 2-year follow up (0% for grade 0 and 27.5% for grade 3).

The authors concluded that the severity grading scale correlated well with risk of recurrence. They recommended additional research to provide stronger validation of the scale.

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