{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:04:18Z","timestamp":1774242258343,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100019916","name":"Spinnaker Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019916","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sacrococcygeal pilonidal sinus disease (SPD) is a chronic inflammatory condition that can significantly impact quality of life. While recurrence and surgical site infection (SSI) rates are well documented, less is known about how different surgical techniques affect patient\u2010reported outcome measures (PROMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed mixed methods, including standardised mail questionnaires and telephone interviews (May\u2013September 2020), to conduct a multi\u2010centre retrospective decade follow\u2010up review of definitive SPD surgery participants from Western Australia. Six surgical technique groups were analysed: Karydakis flap (KF), modified Karydakis flap (MKF), Limberg flap (LF), modified Limberg flap (MLF), other flap techniques (OFT) and secondary intention healing techniques (SIT). PROMs assessed included body image, cosmesis, confidence, functional recovery and overall satisfaction\u2014secondary outcomes examined recurrence, SSI and other complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 136 patients met the inclusion criteria. MLF and OFT achieved the fastest functional recovery, with median return\u2010to\u2010work times of 14 and 21\u2009days, respectively, compared to 60\u2009days for SIT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). MKF and LF achieved the highest body image and cosmetic satisfaction scores (medians of 20 and 19), whereas SIT and OFT scored the lowest. MKF yielded the highest overall satisfaction (100%). SIT was associated with the highest recurrence rate (52.2%) and SSI rates (30.4%), while MLF and MKF combined had low recurrence rates with favourable PROMs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Flap\u2010based techniques, particularly the MKF and MLF, offer an optimal balance of functional recovery, cosmetic outcomes and low recurrence rates. Incorporating PROMs into SPD surgical planning can better align treatment with patient priorities and the underlying pathophysiology of the disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70330","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:25:08Z","timestamp":1760167508000},"page":"525-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sacrococcygeal Pilonidal Sinus Disease: A Decade\u2010In\u2010Review of Patient\u2010Reported Outcome Measures"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-4283","authenticated-orcid":false,"given":"Munyaradzi G.","family":"Nyandoro","sequence":"first","affiliation":[{"name":"The University of Western Australia  Perth Australia"},{"name":"Fiona Stanley Hospital  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary M. K.","family":"Teoh","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen G.","family":"Maclean","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Thompson","sequence":"additional","affiliation":[{"name":"Rockingham General Hospital  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Harry Perkins Institute of Medical Research Fiona Stanley Hospital  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00337585"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(02)00062-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-003-2725-x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6850.410"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1992.tb07208.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1272823"},{"issue":"2","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1463-1318.2010.02473.x","article-title":"Primary Closure or Rhomboid Excision and Limberg Flap for the Management of Primary Sacrococcygeal Pilonidal Disease? A Meta\u2010Analysis of Randomized Controlled Trials","volume":"14","author":"Horwood J.","year":"2012","journal-title":"Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland Journal"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-014-1149-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/110241599750006875"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e31819f6189"},{"issue":"4","key":"e_1_2_9_12_1","first-page":"201","article-title":"Assessment of Karydakis Technique as Compared With Midline Closure for the Management of Chronic Pilonidal Sinus","volume":"12","author":"Sakr M.","year":"2006","journal-title":"Urogynecology"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31829d2616"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1333-y"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.10.001"},{"issue":"1","key":"e_1_2_9_16_1","article-title":"Healing by Primary Versus Secondary Intention After Surgical Treatment for Pilonidal Sinus","volume":"2010","author":"Al\u2010Khamis A.","year":"2010","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481307901217"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-009-0804-1"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000520"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae237"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001237"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-015-1369-3"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-016-1463-7"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s101510200005"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-013-0982-2"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.08.042"},{"issue":"5","key":"e_1_2_9_27_1","article-title":"Surgical Practice Parameters for the Definitive Management of Sacrococcygeal Pilonidal Sinus Disease: Surgeons' Perspective","volume":"15","author":"Nyandoro M. 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