{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:39:14Z","timestamp":1776994754744,"version":"3.51.4"},"reference-count":7,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pilonidal sinus disease (PNS) in children and adolescents lacks standardised management pathways. Minimally invasive and outpatient\u2010based strategies are increasingly adopted, but paediatric\u2010specific data remain limited. This study evaluated outcomes following implementation of a structured, tiered outpatient pathway. A retrospective single\u2010centre cohort study was conducted including patients aged \u2264\u200918\u2009years treated for PNS between February 2023 and August 2024. Management followed a stepwise protocol: structured conservative care, in\u2010clinic debridement and operative intervention (trephination or limited excision) for refractory or severe disease. Primary outcome was recurrence after documented healing. Secondary outcomes included time to healing, clinic utilisation and associations with clinical variables. 69 patients were included (median age 15\u2009years [IQR 14\u201316]; 64% male). Twenty\u2010three patients (33.3%) required operative management. Recurrence occurred in 6\/23 (26.1%) in the operative group and 1\/46 (2.2%) in the non\u2010operative group (Fisher's exact\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0045). Median follow\u2010up duration did not differ significantly between groups. Prior infection at presentation showed a numerical but not statistically significant association with recurrence. Time to healing was prolonged in both groups and did not differ significantly. Within a structured outpatient pathway, paediatric patients demonstrated low overall recurrence rates. Conservative management was associated with lower recurrence; however, patients undergoing operative intervention likely represented a more severe subgroup. Prospective severity\u2010adjusted studies are required to define optimal paediatric wound management strategies for PNS.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70907","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T02:40:06Z","timestamp":1776912006000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive, Maximally Effective: Outpatient Strategies for Paediatric Pilonidal Disease"],"prefix":"10.1111","volume":"23","author":[{"given":"Collette Teresa","family":"Donnelly","sequence":"first","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noora","family":"Al Shahwani","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriza","family":"Que","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald James Lopez","family":"Roxas","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Aquino","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biji","family":"Oommen","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azka","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-2238","authenticated-orcid":false,"given":"Maraeh","family":"Mancha","sequence":"additional","affiliation":[{"name":"Sidra Medicine  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2025.162267"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1016\/j.jpedsurg.2019.02.055","article-title":"The Management of Pilonidal Disease: A Systematic Review","volume":"54","author":"Grabowski J.","year":"2019","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jpedsurg.2019.09.074","article-title":"Improving Resource Utilization and Outcomes Using a Minimally Invasive Pilonidal Protocol","volume":"55","author":"Delshad H. R.","year":"2020","journal-title":"Journal of Pediatric Surgery"},{"issue":"2","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/DCR.0000000000001237","article-title":"The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease","volume":"62","author":"Johnson E. K.","year":"2019","journal-title":"Diseases of the Colon and Rectum"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/j.jpedsurg.2020.11.012","article-title":"A Minimally Invasive Pilonidal Protocol Improves Quality of Life in Adolescents","volume":"56","author":"Henry O. S.","year":"2021","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s10151-023-02870-7","article-title":"Non\u2010Excisional Techniques for the Treatment of Intergluteal Pilonidal Sinus Disease: A Systematic Review","volume":"27","author":"Huurman E. A.","year":"2023","journal-title":"Techniques in Coloproctology"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.5526"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70907","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.70907","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70907","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:05:51Z","timestamp":1776992751000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/iwj.70907"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70907","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70907"}}