• Igors Iesalnieks, Sina Deimel, Carl Zülke, and Hans J Schlitt.
• Department of General and Visceral Surgery, Marienhospital Gelsenkirchen, Germany. i.iesalnieks@marienhospital.eu
• J Dtsch Dermatol Ges. 2013 Oct 1; 11 (10): 1001-5.

BackgroundSmoking 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 MethodsConsecutive 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.ResultsSix 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).ConclusionsSmoking 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.© The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

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