Adding gauze sweep technique to pit-picking procedure increases hair removal and lowers recurrence rate of pilonidal disease.
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INTRODUCTION: Pit-picking (PP) procedure has been used to treat pilonidal patients, with the main goal of removing all hair within the pilonidal sinus. We hypothesized that adding a gauze sweep (GS) technique to PP could increase hair removal and decrease recurrence rate. METHOD: Consecutive pilonidal patients who underwent PP 2/2021-9/2024 were selected. Starting 3/2023, the GS technique was added during PP. Patient demographics, procedure details, any hair removed during PP, pilonidal disease recurrence, and follow-up period were recorded. Data were analyzed using chi-squared or t-test; p < 0.05 was statistically significant. RESULTS: 175 total patients were included. From 2/2021-3/2023, 86 patients underwent PP only. Cohort PP had 51 males (59 %) and 35 females (41 %) with a mean presentation age at 18.3 ± 4.1 years and were followed for a mean of 425.5 ± 244.8 days. From 4/2023-9/2024, 89 patients underwent PP with GS. Cohort PP + GS had 52 males (58 %) and 37 females (42 %) with a mean presentation age at 18.3 ± 3.8 years and were followed for a mean of 359.1 ± 316.7 days. There was no difference between cohorts PP and PP + HR in patient sex, presentation age, and follow up length (p > 0.05). 53 patients (62 %) in cohort PP and 75 patients (84 %) in cohort PP + GS had hair removed during the procedure (p < 0.001). The recurrence rate was 11.6 % (10/86) for cohort PP and 1.1 % (1/89) for cohort PP + GS (p = 0.01). CONCLUSION: Addition of GS to PP increased the probability of removing hair from the pilonidal sinus and was associated with a lower recurrence rate. GS should be incorporated into PP procedure. LEVEL OF EVIDENCE: Level IV.