Dear Editor
In response to the article “Diagnosis and management of sacrococcygeal pilonidal disease in primary care,” this report is formulated in order to address the absence of innovative and minimally invasive surgical techniques, namely Pit Picking and the Gips Procedure. While the original article analyzes three conventional off-midline surgical methods, it overlooks these advanced approaches.
Pit Picking, was derived from Dr. Bascom’s concept, focuses on the pits as the initial ause of pilonidal sinuses. This procedure, performed in a doctor’s office under local anesthesia, involves abscess evacuation irrigstion of the affected area, pit removal, deep tissue preservation, and natural wound healing. Notably, traditional methods have 85% recurrence rate, whereas Pit Picking reduces it to 15-20%.
In 2008, the Pit Picking method was transformed into Gips Procedure. This, employs trephines to punch out pits, tract excision and debriment, which leaves the wound open for healing with secondary intention. The recovery time is approximately 14 to 20 days. When one compares the minimally invasive techniques to the traditional approaches which were analyzed within the original article the difference between the reoccurance rate and recovery time are very distinctive.
The new information not only complements but significantly enhances the understanding of available surgical treatment options for pilonidal sinus. It provides important additions regarding the techniques and the anesthesia types involved in the Gips Procedure. Furthermore, this comprehensive perspective highlights the missed information from the original paper, whose importance is to educate the physician and initiate the involvement of such innovative approaches for the patient’s optimal care.
With Regards,
Mr. Marios Kountouris, MUDr
Senior Clinical Fellow in General, Colorectal and Emergency Surgery
Barnet Hospital, Royal Free Trust
Prof Michael Saunders
Consultant General Surgeon
MB BS, BSc(Hons), MSc(Surgical Science), Dip Lap Surg, FRCSEd(Gen.Surg)
Barnet Hospital, Royal Free Trust
Re: Diagnosis and management of sacrococcygeal pilonidal disease in primary care