{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:27:47Z","timestamp":1787704067989,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pilonidal sinus disease (PSD) is a common acquired condition of the sacrococcygeal region; despite numerous described surgical techniques, long\u2010term outcomes remain highly variable. We compared long\u2010term recurrence and postoperative infection among nine surgical techniques in a large single\u2010centre cohort. We retrospectively analysed 2222 patients with primary PSD who underwent surgery between January 2006 and December 2020 at a single tertiary referral centre in Turkey and had a minimum follow\u2010up of 5\u2009years. Patients presenting with recurrent disease were excluded. Nine surgical techniques were evaluated. Recurrence was analysed as a time\u2010to\u2010event outcome using Kaplan\u2013Meier estimates and multivariable Cox proportional hazards regression. The 5\u2010year cumulative recurrence was 7.9% (175\/2222) and postoperative infection 6.9% (154\/2222); overall recurrence was 10.2% (226\/2222). Recurrence and infection differed statistically significantly among surgical techniques (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The lowest recurrence rates were observed with the Karydakis flap (1.5%), Bascom cleft lift (2.3%) and Dufourmentel flap (2.4%). Most recurrences occurred within the first 2\u2009years, with a median time to recurrence of 20\u2009months (IQR 12\u201336). Compared with lay\u2010open treatment, the Karydakis flap (HR 0.19, 95% CI 0.12\u20130.30), Bascom cleft lift (HR 0.25, 95% CI 0.14\u20130.43), Limberg flap (HR 0.32, 95% CI 0.19\u20130.53) and Dufourmentel flap (HR 0.26, 95% CI 0.12\u20130.57) were independently associated with lower risk of recurrence, whereas a higher body mass index (HR 1.05 per 1\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , 95% CI 1.01\u20131.09) and current smoking (HR 1.98, 95% CI 1.54\u20132.55) were independently associated with an increased recurrence risk. Off\u2010midline flap techniques were associated with superior long\u2010term outcomes, with lower recurrence and infection than midline or secondary\u2010healing approaches. Taken together, the findings of this study support the use of the Karydakis flap and Bascom cleft lift as first\u2010line surgical options for PSD management.\n                  <\/jats:p>","DOI":"10.1111\/iwj.71018","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T01:02:16Z","timestamp":1787533336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Treatment Outcomes for Primary Pilonidal Sinus Disease: A Single\u2010Centre Retrospective Study of 2222 Patients (2006\u20132020)"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-300X","authenticated-orcid":false,"given":"Merve","family":"Tokocin","sequence":"first","affiliation":[{"name":"Department of General Surgery University of Health Sciences T\u00fcrkiye, \u0130stanbul Ba\u011fc\u0131lar Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9545-2231","authenticated-orcid":false,"given":"Hakan","family":"Yigitbas","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Health Sciences T\u00fcrkiye, \u0130stanbul Ba\u011fc\u0131lar Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2429-3341","authenticated-orcid":false,"given":"Erkan","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Health Sciences T\u00fcrkiye, \u0130stanbul Ba\u011fc\u0131lar Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5285-6909","authenticated-orcid":false,"given":"Osman Bilgin","family":"Gulcicek","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Health Sciences T\u00fcrkiye, \u0130stanbul Ba\u011fc\u0131lar Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010015\u20101398\u2010y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201020143\u20104"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00337585"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.17227"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010021\u201003944\u20104"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2016.04.001"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010017\u20101722\u20109"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.003018"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae237"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31829d2616"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.17238"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14404"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010025\u201004883\u20100"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.ijd_673_24"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000491324.29246.96"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010014\u20101149\u20105"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.08.021"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010016\u20103669\u20109"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1590\/0100\u20106991e\u201020263822\u2010en"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010019\u201002116\u20105"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010020\u201002060\u20101"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.70003"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010025\u201004921\u2010x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010009\u20100519\u2010x"}],"container-title":["International 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