Publication:

Beyond the scalpel: post-operative outcomes of radial diode laser ablation in sacrococcygeal pilonidal sinus disease

Background Conventional excisional surgery for sacrococcygeal pilonidal sinus disease repays cure with weeks of open wound care. This study evaluated post-operative outcomes of 1470-nm radial diode laser ablation and the factors governing healing.

Methods Fifty consecutive patients underwent curettage and 1470-nm radial diode laser ablation at 10 W in a prospective observational study in Kanpur, India, between October 2024 and February 2026. Age, sex, body mass index, family history, morphological stage, occupational sitting duration, gluteal hair density and hair shaft thickness were tested against healing time, delayed healing beyond 30 days and six-month recurrence, univariably and by multivariable linear regression.

Results Mean age was 25.0±5.3 years and 42 patients (84.0%) were men. Mean operating time was 26.1±8.7 minutes, hospital stay 1.3±0.5 days and day-7 pain 1.2±0.8. Mean healing time was 28.5±10.2 days; 46 patients (92.0%) had no complication and three (6.0%) recurred. Healing time rose with stage (20.1 to 43.5 days; F=22.19, p<0.001), sitting duration (F=5.37, p=0.008), body mass index (r=0.344, p=0.014) and hair density (F=3.61, p=0.035). Delayed healing was associated with advanced stage (76.5% versus 3.0%), overweight (77.8% versus 17.1%), sitting beyond six hours daily (54.5% versus 7.1%) and dense gluteal hair (53.3% versus 17.1%; all p≤0.016). Hair shaft thickness predicted nothing. On multivariable regression only stage remained independent (B=5.60 days per stage, p<0.001; R²=0.737). No factor predicted recurrence.

Conclusions Laser ablation achieved day-care surgery with minimal pain and 6.0% recurrence. Morphological stage governed healing; body mass index, sedentary work and hair density acted through it.