Long term outcome of the Bascom cleft lift procedure for adolescent pilonidal sinus

Purpose: The purpose of this study was to assess whether adolescent patients who heal their pilonidal sinus disease with the Bascom cleft lift have a sustained result, or if younger age puts them at increased risk of relapse. Methods: Twenty-two consecutive patients (18 male, median age 16 years at surgery) who underwent Bascom procedures were contacted regarding long term outcomes following surgery. Additional clinical data were collected from the medical records of the subjects. Results: Seventeen of 22 (77%) patients studied were completely healed at median 27 (range 9–268) days after a single procedure. Three of 22 (14%) required a second procedure during follow up. Of these, all three healed fully after the second procedure. Based on intention to treat, 20 of 22 (91%) patients had complete healing documented at a median of 31 days after initial surgery. Half of the patients were fully healed and back to normal activities by one month and 68% by two months. Two patients (9%) failed surgery and had ongoing pilonidal disease. Fifteen of 22 (68%) patients completed a follow-up survey at a median of 44 months elapsed from surgery. All responders were fully healed, and none reported relapse or further surgeries. Conclusions: Excision of pilonidal sinus disease by the Bascom procedure resulted in lasting cure for most adolescent patients studied. A small proportion of patients failed to heal in the first year and had ongoing pilonidal disease. No late failures occurred. Level of evidence: Level III, nonexperimental observational study.