Ann Surg Treat Res.  2025 Feb;108(2):124-134. 10.4174/astr.2025.108.2.124.

The power of platelet-rich plasma on operated pilonidal disease: a prospective randomized controlled trial

• Chousein B
• Olcucuoglu E
• Kaya IO

• KMID: 2564251
• DOI: http://doi.org/10.4174/astr.2025.108.2.124

Abstract

Purpose
Pilonidal sinus disease is a chronic inflammatory disease that affects approximately 1% of the population. Although many treatment methods have been described, there is no consensus on the exact treatment method. This study was conducted to evaluate the wound healing-promoting effect of platelet-rich plasma (PRP) in patients treated using the unroofing and curettage technique.
Methods
A total of 140 patients diagnosed with pilonidal sinus disease were included in the study. The patients were randomized into 2 groups; one group was followed up with a standard dressing after the operation, and the patients in the other group were treated with PRP in addition to the standard dressing. In this study, the wound healing rate between the 2 groups was determined as the primary objective.
Results
In postoperative follow-up, a difference in wound healing rate was detected on postoperative day 10 (P = 0.007). While the average wound healing time of the patients in the control group was 41.1 ± 11.0 days (median, 40; range, 20–65), it was 23.6 ± 8.5 days (median, 25; range, 6–45) in the PRP group (P < 0.001). It was determined that the wound closure time of patients in the PRP group was faster.
Conclusion
In our prospective randomized study, we found that PRP significantly increased the wound healing rate and patient comfort, with recurrence rates below 1% and minimal pain. We think that it should be the first-choice method before operations that cause extensive tissue loss, such as flap surgery.

Keyword

Curettage; Pilonidal cyst; Pilonidal sinus; Platelet-rich plasma; Wound healing

Figure

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  Fig. 1 Fistulotomy and curettage technique. (A, B) Exploration of the Area With the help of adhesive tapes. (C) Cleaning of the operation area with polyvinyl iodine. (D) Draping of the patient. (E) Application of local anesthesia. (F) Identification of Sinus tract with the help of mosquito forceps. (G) Skin incision with scalpel. (H) Curretage of the cavity with the help of dry gauze. (I) The cavity after the curretage. (J) Measurement of the cavity with physiological saline. (K) Cavity applied Thiociline cream (Abdi İbrahim). (L) Dressing after surgery. Source: Bourak Chousein Archive.

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  Fig. 2 Flowchart of the study. PRP, platelet-rich plasma.

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  Fig. 3 Comparison of cavity measurements of the platelet-rich plasma (PRP) and control groups in the postoperative period.

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  Fig. 4 Wound healing in the postoperative period. Postoperative days 2 (A), 4 (B), 6 (C), 10 (D), 15 (E), and 20 (F). Source: Bourak Chousein Archive.

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