In an open access article, from Dr Dietrich Doll from Germany, which came out in June of 2022, 327 patients with pilonidal disease were treated with either pit picking, open excision, or a Limberg Flap.
The article also demonstrated a 44% failure rate at 10 years for patients who had open excision – which approximates the 50/50 number that many surgeons equate with this procedure.
The data was statistically analyzed and predicted out to five years for the pit picking patients.
They found that the five year recurrence rate in the pit picking patients was 62%. In other words, approximately 2 out of 3 patients had failure within 5 years – about a 12% failure rate per year. Although this is a lower success rate than some other articles, it confirms what many surgeons intuitively have found, and it is why many of us do not offer pit picking, or any of the minimally invasive operations.
This series also showed a 22% failure rate in the Limberg Flap patients. This is in contrast to the failure rate of the cleft lift procedure, which Dr Immerman demonstrated in his 2021 article, which was 3.4% at 3 years using the same type of statistical analysis. That article can be viewed by following this link. Most likely, dedicated pilonidal surgeons who perform the cleft lift procedure frequently, have similar success rates.